An inexpensive ex-vivo porcine laparoscopic Nissen fundoplication training model.

BACKGROUND: We recently implemented the use of an ex-vivo porcine model to teach residents the fundamentals of performing a laparoscopic Nissen fundoplication. METHODS: Residents were trained using intact porcine esophagus, stomach, and spleen placed in a standard video-trainer. They were later asked to complete a survey containing a course evaluation. RESULTS: Sixteen residents (R1-R4) completed the survey. They agreed that (1) the exercise was a valuable use of their limited time, (2) repeating the exercise will be of additional benefit, (3) it will improve their ability to perform or assist in an actual case in the OR, and (4) the surgical principles learned using the model will transfer to other laparoscopic cases. Significant subjective improvements were reported in resident comfort level in assisting in or performing a laparoscopic Nissen fundoplication. CONCLUSIONS: The use of an inexpensive ex-vivo porcine training model increases resident comfort level in performing a Nissen fundoplication in the operating room.     

Profile of ocular injury in pediatric age group

目的：研究北印度三级转诊中心儿童眼外伤的临床特征。

方法：基于医院的流行病学研究。包括所有年满16岁的眼外伤儿童。记录关于患者的社会经济状况,治疗手段和出院情况。随访3mo,记录初始和最终视力。眼部创伤分类指南和Birmingham眼部创伤术语用于眼外伤的定义和分类。社会经济地位是根据改良B.G. Prasad分类和Kuppuswamy社会经济级别分级的。

结果：在42例儿童中,男女比例为3.6：1。发生在11～16岁儿童眼外伤最多(50%)。大多数儿童(59.52%)属于较低的社会经济阶层,且均为农村背景。在家中发生眼外伤的儿童为20例(47.61%),其次在学校,游乐场和街道发生为6例(14.28%)。其中开放性眼外伤19例(45.24%),闭合性眼外伤23例(54.75%)。因木棍、石头、烟花、跌倒、玩具而受伤的儿童数量分别为12例(28.57%),5例(11.90%),3例(7.14%),3例(7.14%)和2例(4.76%)。 17例(40.47%)儿童需要药物治疗,25名(59.53%)需要手术治疗。

结论：农村地区和经济条件较差的男童更易患眼外伤。儿童在家里更易患眼外伤。木棍和石头是引起眼外伤最常见的因素。开放性眼外伤的患病率更高且视力不良增多。需要进一步的以人群为基础研究以补充本研究。基于此,人们可以计划在该地区实施一项长期的政策以预防儿童眼外伤。     

Cytomegalovirus-associated pseudotumor simulating gastric malignancy in acquired immunodeficiency syndrome: a case report with review of literature

We present a case of cytomegalovirus (CMV)-induced pseudotumor of the gastric antrum. Although affliction of the entire gastrointestinal tract with CMV has been described, localization to the stomach and especially the gastric antrum is rare. Kaposi's sarcoma and non-Hodgkin's lymphoma are recognized causes of bowel thickening and obstruction in patients with AIDS, but CMV is an extremely rare cause, with only four cases of CMV-induced pseudotumor reported in the English literature. As the duration of opportunistic infections and length of survival of patients with AIDS increase, CMV pseudotumors are not likely to remain unique. This mass lesion should be included in the differential diagnosis of AIDS patients, along with Kaposi's sarcoma and non-Hodgkin's lymphoma.     

Platelet Derived Growth Factor (PDGF) autocrine components in human tumor cell lines

Tumor cells may stimulate their own proliferation through an autocrine mechanism by simultaneously producing growth factors and growth factor receptors. We now report that numerous human tumor-derived cell lines simultaneously express the genes for platelet-derived growth factor (PDGF) A and B chains and the PDGF receptor (PDGF-R). Measurement of mRNA transcribed from these genes showed that among 16 malignant glioma cell lines tested, 15 expressed the PDGF A gene, 12 expressed the PDGF B gene, and 13 expressed the PDGF-R gene. Of three osteosarcoma lines, three expressed PDGF A, two expressed PDGF B, and three expressed PDGF-R. For eight malignant melanoma lines, seven expressed PDGF A, five expressed PDGF B, and three expressed PDGF-R genes. Thus, 13 of 16 malignant glioma, 3 of 3 osteosarcomas, and 3 of 8 malignant melanoma cell lines expressed the PDGF receptor gene and either or both PDGF genes. Five cell lines were tested for production of biologically active PDGF and PDGF receptor protein. Media conditioned by each of the five cell lines induced tyrosine phosphorylation of a protein identical in size to the PDGF receptor. These five cell lines also produced PDGF receptor protein as measured by Western blot analysis or metabolic labeling and immunoprecipitation using PDGF-R antibodies. The PDGF receptors of these cell lines were activated by human platelet PDGF or by recombinant AA or BB homodimers. Intracellular interaction of these receptors with the growth factor simultaneously produced may provide continuous stimulation to the proliferation of these cells.     

Unilateral hydrocephalus in adults

The authors report 14 cases of unilateral hydrocephalus in adults. Headache was the most common presenting symptom. Unilateral hydrocephalus was documented in each patient with computed tomography scans; magnetic resonance imaging was also used in seven patients in the latter part of the series. Unilateral hydrocephalus was caused by tumor (seven patients), venous angioma (one patient), ependymal cyst (one patient), postinflammatory gliosis (one patient), and was idiopathic in four patients. The primary surgical treatment was craniotomy with fenestration of the septum pellucidum, which relieved symptoms in eight of nine patients for whom long-term follow-up data were available.     

Behavioral responsiveness in sleeping older adults

The control of behavior by stimuli presented during sleep, and related effects on sleep and daytime sleepiness, were investigated in 17 older (age = 60-74 years) adults. Experimental subjects (N = 8) were trained while awake to terminate tone presentations by taking a deep breath. Tones were then presented following sleep onset for four consecutive nights with a mean intertone interval of 4 min. Control subjects (N = 9) slept in the laboratory but did not receive tones. The daytime sleepiness of both groups was assessed by recording latency to sleep onset in a morning and afternoon nap test. It was found that the experimental subjects responded reliably to the tones. Responding, however, was almost invariably accompanied by disruption of sleep and overall sleep structure was markedly altered. Surprisingly, the daytime sleepiness of experimental subjects was not reliably greater than that of control subjects.     

Acute myocardial infarction in a young man with sickle cell disease

Sickle cell disease is considered protective against large vessel coronary artery disease. Although sickle cell patients do develop myocardial degeneration and fibrosis at a higher rate than age-matched controls, they rarely suffer from an acute myocardial infarction. We present a case of a 29-year-old man with sickle cell disease who presented with an acute non-ST segment myocardial infarction. In sickle cell patients who present with chest pain as an element of their sickle cell crisis, the clinician must consider acute myocardial infarction in the differential along with more common entities like acute chest syndrome.     

Analysis of youtube as a source of information for peripheral neuropathy

Introduction: YouTube is an important resource for patients. No study has evaluated the information on peripheral neuropathy disseminated by YouTube videos. In this study, our aim was to perform a systematic review of information on YouTube regarding peripheral neuropathy. Methods: The Web site ( www.youtube.com ) was searched between September 19 and 21, 2014, for the terms “neuropathy,” “peripheral neuropathy,” “diabetic neuropathy,” “neuropathy causes,” and “neuropathy treatment.” Results: Two hundred videos met the inclusion criteria. Healthcare professionals accounted for almost half of the treatment videos (41 of 92; 44.6%), and most came from chiropractors (18 of 41; 43.9%). Alternative medicine was cited most frequently among the treatment discussions (54 of 145, 37.2%), followed by devices (38 of 145, 26.2%), and pharmacological treatments (23 of 145, 15.9%). Conclusions: Approximately half of the treatment options discussed in the videos were not evidence‐based. Caution should be exercised when YouTube videos are used as a patient resource. Muscle Nerve 53 : 27–31, 2016