Simultaneous laparoscopic hiatal hernia repair and pyloroplasty for a type 3 hiatal hernia with post-ESD pyloric stenosis for early gastric cancer

We present a case of early gastric cancer in the pylorus with a type 3 hiatal hernia, which was treated by endoscopic submucosal dissection (ESD). A 70-year-old man was referred to our hospital with a hiatal hernia. Endoscopy revealed early gastric cancer, and we performed an ESD adaptation at the pylorus. The ESD was successful, but post-ESD pyloric stenosis occurred. Symptoms of hiatal hernia worsened because of the pyloric stenosis. Laparoscopic hiatal hernia repair with Toupet fundoplication and Heineke-Mikulicz pyloroplasty was simultaneously performed. The postoperative course was good, and follow-up after discharge was uneventful. To our knowledge, there have been no reports in which laparoscopic hiatal hernia repair, fundoplication, and pyloroplasty were simultaneously performed for a substantial hiatal hernia with post-ESD pyloric stenosis.     

Effect of nickel on the mineralization of hydrocarbons by indigenous microbiota in Kuwait soils

Assessment of nickel contents in soil samples in Kuwait indicated only a minor difference in concentration in hydrocarbon‐contaminated (86 mg kg^–1 soil) and non‐contaminated soils (84 mg kg^–1 soil). The potential inhibitory effects of nickel on the number of hydrocarbon degraders, and hydrocarbon utilization were investigated over a wide range of nickel concentrations to span concentrations observed in the soil. Nickel addition, as nickel sulphate, to soil samples reduced the number of hydrocarbon degraders in all samples by a wide range (15–96%) depending on concentration and the hydrocarbon substrate utilized. Similarly, the metabolic activities were affected as observed in mineralization (3–60%) of soils amended with various concentrations of nickel. The inhibitive effects of nickel on hexadecane and crude oil utilization were minimal but were significantly higher with naphthalene (P < 0.05) in both hydrocarbon‐contaminated and non‐contaminated soils. Polarographic determination of hydrocarbons induced oxygen uptake rate demonstrated the tendency of nickel to significantly inhibit (P < 0.05) the oxidation of polyaromatic hydrocarbons compared to aliphatic hydrocarbons. (© 2009 WILEY‐VCH Verlag GmbH & Co. KGaA, Weinheim)     

Dual burden of body weight among Iranian children and adolescents in 2003 and 2010: the CASPIAN-III study

Introduction

Our aim was to compare changes of body mass index (BMI) and waist circumference (WC) curves of Iranian children by comparing the results of two national surveys of a surveillance program, i.e. CASPIAN-I (2003–2004) and CASPIAN-III (2009–2010). The second objective was to evaluate the prevalence of obesity, overweight and underweight among 10–18-year-old Iranian children and adolescents.

Material and methods

This study was performed among students who were selected by multistage random cluster sampling from urban and rural areas of 27 provinces of Iran, as part of a national survey of school student high risk behavior entitled CASPIAN-III, conducted in 2009–2010.

Results

We evaluated 5088 school students (50.2% boys). In rural areas, underweight was more common in boys and overweight and obesity in girls. In urban areas underweight and obesity were more common in boys, whereas overweight was more common in girls. The highest prevalence of underweight (23.5%) was seen in students aged 13 years and the lowest (11.4%) in those aged 18 years. Underweight was significantly more common in rural than in urban areas (22.1% vs. 15.8%, respectively, p < 0.0001) and overweight/obesity was more common in urban than in rural areas. Compared with the findings in 2003–2004, the overall prevalence of elevated body mass index (16.6%) including obesity (9.1%) and overweight (7.5%) as well as underweight (17.5%) increased from 2003 to 2010.

Conclusions

In recent years, the double burden of nutritional disorders has increased among Iranian children and adolescents, especially in rural areas. This change may be related to epidemiologic transition, notably in terms of nutrition transition and rapid changes in lifestyle habits. This finding is an important issue for policy-makers for interventional preventive programs.     

Comparison of an ESAT-6/CFP-10 peptide-based enzyme-linked immunospot assay to a tuberculin skin test for screening of a population at moderate risk of contracting tuberculosis

Screening for latent tuberculosis infection (LTBI) with the Mantoux tuberculin skin test (TST) has many limitations including false-positive results due to Mycobacterium bovis bacillus Calmette-Guérin (BCG) vaccination. Three hundred ninety adult inmates with normal screening chest radiographs in a county jail were evaluated for LTBI using TST and an ESAT-6/CFP-10 peptide-based enzyme-linked immunospot assay (T-SPOT.TB). LTBI prevalence rates were 19.0% and 8.5% by T-SPOT.TB and TST, respectively. Overall agreement between test results was 82.8% (kappa = 0.29). Positive T-SPOT.TB results were significantly associated with increased age (odds ratio [OR], 1.04; 95% confidence interval [CI], 1.01 to 1.06) and intravenous drug use history (OR, 2.92; 95% CI, 1.36 to 6.27). Positive TST results were significantly associated with increased age (OR, 1.06; 95% CI, 1.02 to 1.09) and foreign birth (OR, 6.61; 95% CI, 1.98 to 22.01). Discordant covariates between the assay results included increased age (OR, 0.96; 95% CI, 0.94 to 0.99) and intravenous drug use history (OR, 0.41; 95% CI, 0.19 to 0.88). T-SPOT.TB reactivity is unaffected by prior BCG vaccination. T-SPOT.TB may be more sensitive than TST in diagnosing LTBI among a moderate risk population of inmates, particularly those with intravenous drug use history. Longitudinal studies are needed to assess the positive predictive value of T-SPOT.TB in identifying those most likely to convert to active disease in general populations as well as in high-risk subpopulations.     

Infection during Infancy and Long Incubation Period of Leprosy Suggested in a Case of a Chimpanzee Used for Medical Research

The length of the incubation period of leprosy following Mycobacterium leprae infection has never been conclusively determined, owing to the lack of a method to demonstrate the presence of an asymptomatic infection. We report a rare case of leprosy in a chimpanzee in which a 30-year incubation period was strongly suggested by single nucleotide polymorphism (SNP) analysis.