Modified onlay technique for the repair of the more complicated incisional hernias: single-centre evaluation of a large cohort

Background  

The repair of incisional hernias remains a challenge for the general surgeon. Indications for surgery are severe bowel obstruction, as well as aesthetic problems. There are various surgical methods to correct these hernias, with varying results. However, the gold standard has not yet been found. Both laparoscopic repair and the component separation technique (CTS) have proven to be acceptable techniques; however, they are not always suitable for resolving the more complicated abdominal wall defects, i.e. after open-abdomen treatment or fascial necrosis. In our hospital, we developed a new onlay technique which we have evaluated in the following research.     

Using next generation sequencing to develop microsatellite markers for the endangered Grevy’s zebra (Equus grevyi)

Today the highly endangered Grevy’s zebra (Equus grevyi) inhabits only Kenya and Ethiopia. It is necessary to plan a conservation program that includes genetic management. However, there is little information on Grevy’s zebra genetics until now. We developed 21 novel microsatellite markers for the Grevy’s zebra using next-generation sequencing. Forty-one Grevy’s zebra individuals in captivity were analyzed. The number of alleles, observed and expected heterozygosity ranged from 2 to 9 (mean 4.6), 0.075–0.854 (mean 0.523) and 0.072–0.784 (mean 0.529), respectively. Cumulative probability of identity among siblings for all loci was 2.78 × 10^?6. We developed the first microsatellite marker derived from the Grevy’s zebra genome. These novel microsatellite loci will be useful to study in population genetics, individual identification and parentage studies for conservation.     

Effect of increased <Superscript>99m</Superscript>Tc/<Superscript>99</Superscript>Tc ratios on count rates in sentinel node procedures: a randomised study

The aim of this study was to evaluate the count rates of sentinel lymph nodes (SLNs) in patients with breast cancer in the operating theatre, using ^99mTc-Nanocoll with different ratios of technetium-99m to technetium-99. After written informed consent had been obtained, we tested different ratios of ^99mTc/⁹⁹Tc-Nanocoll in a double-blinded randomised study performed in 161 patients. Twenty-five MBq/g ^99mTc-colloid albumin was prepared in vacuum. In 87 patients (group A) a 2-h elution was used and in 74 patients (group B) a 24-h elution was used. Patients were subcategorised into subgroups 1 and 3, in which an SLN procedure for breast carcinoma was performed simultaneously with lumpectomy, and subgroups 2 and 4, in which an SLN procedure was performed 2–3 weeks after prior excision biopsy. All patients were injected along the lateral border of the areola (two injections: 50 MBq/0.3 ml intradermally and 50 MBq/2 ml intraparenchymally). Ex vivo measurement of count rates was performed with a gamma probe. Comparing groups A and B in respect of registered counts per second (cps) of excised SLNs, a significant difference was found (P<0.004). When comparisons were made between subgroups 1 and 2 (2-h elution) and between subgroups 3 and 4 (24-h elution) in respect of registered cps of excised SLNs, no significant difference was found (subgroup 1 vs 2, P=0.825; subgroup 3 vs 4, P=0.915). Use of a 2-h elution in vacuum yielded a significantly higher count rate of maximum specific activity of ^99mTc-colloid albumin in SLNs than was achieved using a 24-h elution in vacuum. SLN procedures performed 2–3 weeks after prior excision biopsy proved reliable as compared to SLN procedures performed simultaneously with lumpectomy.     

Risk factors associated with self‐reported symptoms of digital ischemia in elite male volleyball players in the Netherlands

One in every four elite male volleyball players in the Netherlands reported blue or pale digits in the dominant hand. Little is known about risk factors. To assess whether personal‐, sports‐, and work‐related risk factors are associated with these symptoms in these volleyball players, a survey was performed among elite male volleyball players in the Dutch national top league and in the Dutch beach volleyball team. The questionnaire assessed the presence of symptoms and risk factors. Binary logistic regression was performed to calculate odds ratios (ORs). A total of 99 of the 107 athletes participated – a response rate of 93%. Two sports‐related risk factors were associated with symptoms of blue or pale digits: 18–30 years playing volleyball [OR = 6.70; 95% confidence interval (CI) 1.12–29.54] and often/always performing weight training to increase dominant limb strength (OR = 2.70; 95% CI 1.05–6.92). No significant other sports‐, personal‐, or work‐related risk factors were found. Playing volleyball for more than 17 years and often/always performing weight training to increase dominant limb strength were independently associated with an increased risk on ischemia‐related complaints of the dominant hand in elite male volleyball players.     

Esophagus resection and reconstruction without thoracotomy; initial results

From November 1, 1986 to December 1, 1989, 100 patients with squamous cell carcinoma (n = 35), adenocarcinoma (n = 61) or 'other' carcinoma (n = 4) of the oesophagus or the gastroesophageal junction were resected and reconstructed. There were 71 men and 29 women with a mean age of 63 years (35-77 yrs). In 80 patients the tumour was localised in the distal oesophagus or the gastroesophageal junction. In 20 patients the tumour was localised more proximally. In all patients the oesophageal resection was performed transhiatally without thoracotomy with blunt dissection. Reconstruction was performed with a stomach tube (n = 84) or colonic interposition (n = 16). Postoperative pulmonary complications were seen in 25% of the patients. Leakage of the cervical anastomosis was seen in 6 patients. In-hospital mortality was 4%. Oesophageal resection without thoracotomy appears to be an operation with reduced morbidity leading to a marked decrease in postoperative mortality.     

Developmental delay in breastfed children due to inadequate diet of the mother

Two infant boys of 7 and 12 months respectively who presented with symptoms of failure to thrive and developmental delay were diagnosed with vitamin B12 deficiency. This deficiency is a rare condition in infants living in developed countries. It does occur, however, in infants who are breastfed by mothers with an inadequate diet. Both of the children studied were breastfed by vegetarian mothers. Following vitamin suppletion, both children showed signs of recovery. The importance of considering vitamin deficiencies in similar infants presenting with failure to thrive is emphasized. Moreover, maternal dietary habits in breastfed children should be checked. To prevent irreversible neurological damage, early recognition of any nutritional deficiencies is important.     

Development of a Fluorescent Microsphere Immunoassay for Detection of Antibodies against Porcine Reproductive and Respiratory Syndrome Virus Using Oral Fluid Samples as an Alternative to Serum-Based Assays

For effective disease surveillance, rapid and sensitive assays are needed to detect antibodies developed in response to porcine reproductive and respiratory syndrome virus (PRRSV) infection. In this study, we developed a multiplexed fluorescent microsphere immunoassay (FMIA) for detection of PRRSV-specific antibodies in oral fluid and serum samples. Recombinant nucleocapsid protein (N) and nonstructural protein 7 (nsp7) from both PRRSV genotypes (type I and type II) were used as antigens and covalently coupled to Luminex fluorescent microspheres. Based on an evaluation of 488 oral fluid samples with known serostatus, the oral fluid-based FMIAs achieved >92% sensitivity and 91% specificity. For serum samples (n = 1,639), the FMIAs reached >98% sensitivity and 95% specificity. The assay was further employed to investigate the kinetics of the antibody response in infected pigs. In oral fluid, the N protein was more sensitive for the detection of early infection (7 and 14 days postinfection), but nsp7 detected a higher level and longer duration of antibody response (28 days postinfection). In serum, the antibodies specific to nsp7 and N proteins were detected as early as 7 days postinfection, and the responses lasted more than 202 days. This study provides a framework from which a more robust assay could be developed to profile the immune response to multiple PRRSV antigens in a single test. The development of oral fluid-based diagnostic tests will change the way we survey diseases in swine herds and improve our ability to cheaply and efficiently track PRRSV infections in both populations and individual animals.     

Effect of fluoride toothpastes on enamel demineralization

Background  

It was the aim of this study to investigate the effect of four different toothpastes with differing fluoride compounds on enamel remineralization.