Gastroplasty for morbid obesity

With the advent of autosuture devices, gastric partitioning procedures have recently become popular surgical treatment of morbid obesity. One such procedure is Gomez gastroplasty. Using an autosuture device a small gastric fundal pouch, having a reservoir capacity of 60 ml and communicating with the remaining stomach through a 12 mm stoma is created along the greater curvature of the stomach. A 3-0 polyprolene internal seromuscular suture is used to reinforce the stoma without incising the stomach. This gastroplasty is extremely attractive because of the disarming simplicity of the procedure and its noninterruption of the normal sequence of the digestive tract.This report is based on a joint review of 280 cases subjected to Gomez gastroplasty to combat morbid obesity. Postoperative radiological evaluation and the spectrum of observed complications are herein described.     

Incidence trends and projections for childhood cancer in Ontario

Studies of cancer incidence patterns and trends can provide useful measures of health burden and possible disease etiology, which can aid the planning of cancer care services. This report aims to characterize trends in incidence of childhood cancer, and to assess the implications of these trends by generating incidence projections to 2015. Cancer incidence data were obtained from the database of the Pediatric Oncology Group of Ontario (POGO), which has registered all cancer cases in Ontario since 1985. Annual incidence rates were calculated with census-based population estimates for the 1986-2001 period. Poisson regression models were used to analyze trends, and to calculate projected numbers of cases up to the year 2015. From 1986 to 2001, 5,163 cancer cases occurred among children aged 0-14. Leukemia, CNS tumors and lymphomas were the most common cancers. The number of incident cases increased by 14%, from 296 in 1986 to 336 in 2001. For all cancers, average annual age-standardized rates increased from 147 per million in 1991 to 157 per million in 2001. Over the next 15 years, the 0-14 year population is expected to decrease from 2.28 million in 2000 to 2.13 million in 2015. A marginally statistically significant trend in incidence was projected for all cancers combined (0.5% increase per year p < 0.10) and a statistically significant increase for lymphomas, (1.2% per year 95% CI = 0.0-3.9%). During this period, the number of cases of leukemia and CNS tumors is expected to remain relatively stable. The number of cases of all cancers is expected to increase by 8%, from the average of 320 in 1995 to approximately 347 in 2015. Understanding of these projections will facilitate health care resource planning.     

Enzyme replacement therapy in a child with Gaucher disease

This case report describes an experience of using recombinant enzyme in a child who was diagnosed as a case of Gaucher disease at the age of 3 years. Regular enzyme replacement therapy has resulted in marked improvement in his hemoglobin level, absolute neutrophil count, platelets and physical growth.     

His bundle recordings in diagnosis of impulse formation in Kent and Mahaim tracts.

His bundle electrograms were recorded in 2 patients with ectopic beats arising in accessory atrioventricular tracts. Case 1 had Wolff-Parkinson-White (WPW) type A and a left-sided Kent tract with a short effective refractory period. Though ectopic impulse formation most probably occurred within the Kent tract itself, a vulnerability-related origin in the ventricular muscle close to the distal end of the Kent tract could not be excluded. In Case 2, with a Mahaim tract extending from His bundle to ventricles, there were three types of QRS morphologies resulting from : (a) atrioventricular conduction exclusively through the normal pathways; (b) atrioventricular conduction through both, normal pathway, and Mahaim tract; and (c) ectopic impulse formation in the Mahim tract. Specialized electrophysiological studies were essential to diagnose these unusual arrhythmias.     

Spindle-cell squamous carcinoma of the esophagus: a tumor with biphasic morphology

Spindle-cell squamous carcinoma of the esophagus is a rare malignant tumor. It is characterized by a large bulky mass in the middle third of the esophagus with a lobulated surface and local expansion of the esophagus. This lesion may be pedunculated and cause relatively little obstruction despite its bulk. The current view, based on ultrastructure and immunohistochemical evidence, has confirmed that the sarcomatous component of the squamous cell carcinoma originates from mesenchymal metaplasia of squamous cells. On the basis of this evidence and clinical behavior, it seems appropriate to consider carcinosarcoma and pseudosarcoma as equivalents and as variants of squamous cell carcinoma. Four patients with spindle-cell squamous carcinoma, an unusual subset of squamous carcinoma, are described, and the salient radiographic and pathologic features of this disorder's distinctive biphasic morphology are discussed.     

Seasonal Effects of Pinealectomy on the Ovary of the Catfish Heteropneustes fossilis (Bloch) Under Normal Photothermal Conditions

Pinealectomy of Heteropneustes fossilis held under normal photoperiod and ambient temperature produced season-dependent effects on ovarian activity. When the fish were pinealectomized in the preparatory phase (early light-responsive period) and maintained until the early prespawning phase, there was an accelerated growth of the ovary, as adjudged from increased gonado-somatic index (GSI), ovarian histology, elevated ovarian total protein and ascorbic acid levels, and an increased level of serum alkali-labile protein phosphorus (vitellogenin). Pinealectomy was ineffective in the prespawning and spawning (late light-responsive phase) and postspawning (light refractory) phases. The results suggest that the pineal exerts an inhibitory effect on the hypothalamo-hypophysial-ovarian axis and synchronizes temporally ovarian activity in response to increasing photothermal conditions such that spawning takes place at a time most suitable for the survival of the young.