Laparoscopic Nissen fundoplication after failed endoscopic gastroplication

Endoscopic techniques to treat gastroesophageal reflux have been developed and approved by the U.S. Food and Drug Administration. One of these techniques is endoscopic gastroplication with the Bard Endocinch device. Although the technique is initially effective, long-term symptom control has not yet been proved. No reports have documented the feasibility of laparoscopic fundoplication after failed endoscopic gastroplication. We report our experience. Ten patients who underwent endoscopic gastroplication subsequently had recurrent symptoms and were referred for laparoscopic antireflux surgery. Eight had typical symptoms of gastroesophageal reflux disease (GERD), whereas two had atypical symptoms. All patients had documented pathologic reflux by 24-hour pH monitoring. Preoperatively, all patients completed the GERD health-related quality of life (HRQL) symptom severity questionnaire. Nine of the 10 operations were completed laparoscopically. The one conversion was carried out because of excessive fat in the hiatal region. No patients had scarring of the esophagus or hiatal region. All patients with typical symptoms improved (decrease in total GERD-HRQL median score from 27 to 4), whereas none of the patients with atypical symptoms did. Six patients had persistent dysphagia for longer than 1 month; two required esophageal dilation. Laparoscopic Nissen fundoplication is feasible after failed endoscopic gastroplication. Symptomatic improvement is similar to that with the de novo operation. However, in some patients, dysphagia may persist longer.     

Isolated dislocation of the carpal scaphoid. A case report with review of the literature

Isolated dislocation of the carpal scaphoid is an extremely rare injury, which is usually accompanied by significant ligamento-capsular lesions. A review of the literature found only 21 reported cases. The aim of this report is to present a single case of isolated radio-palmar dislocation of the scaphoid treated conservatively, which provided a good functional result at 10 years follow up.     

Outcomes in surgical treatment of "idiopathic-like" scoliosis associated with syringomyelia

Patients with "idiopathic-like" spinal deformities associated with syringomyelia were retrospectively reviewed. Ten patients had surgical stabilization of their curvatures with at least a 2-year follow-up, and an additional five patients were evaluated for deformity pattern with <2 years of follow-up. Paralytic curve patterns, scoliosis associated with spina bifida, congenital scoliosis, or other associated syndromes were discarded. All 10 patients with surgery who were followed for an average of 46 months lost 10 degrees correction above, through, or below the instrumented segments. A total of 50% lost correction through the instrumented segments. Anterior fusion stabilized the instrumented portion of the spine better than posterior instrumentation alone. Eighty percent of the 15 patients had thoracic kyphosis >40 degrees. Only one patient was lordoscoliotic. Syringomyelia deformities tend to be kyphoscoliotic in 80% of cases and behave more like paralytic curvatures postoperatively. MRI is recommended for apparent idiopathic scoliotic curvatures that are kyphoscoliotic and not lordoscoliotic.     

PDGF对人神经干细胞分化和甲状腺激素受体表达的影响

[目的]探讨血小板衍生生长因子(Platelet-derived Growth Factor,PDGF)在人神经干细胞(Human Neural Stem Cells,hNSCs)定向分化中的作用,以及在hNSCs分化过程中PDGF对甲状腺激素受体(Thyroid Hormonereceptors,TRs)的表达调控。[方法]用免疫细胞化学方法鉴定分化后的细胞类型,分别用半定量RTPCR法、 ELISA法检测不同诱导条件下hNSCs分化前后TRα1、TRα2、TRβ1在转录与翻译水平上的表达变化。 [结果]PDGF诱导hNSCs分化后NF阳性细胞约占80％;TRα1、α2、β1mRNA表达水平分别比10％胎牛血清诱导分化组上调约40％、30％、10％(P<0．05)。TRα、β蛋白质表达趋势为hNSCs>PDGF诱导分化组>血清诱导分化组(P<0．05)。[结论]PDGF能引发hNSCs向神经元分化,同时在转录与翻译水平上调hNSCs分化后TR各亚型的表达,增强甲状腺激素对中枢神经系统发育的重要调控作用。     

Childhood diabetic neuropathy: a clinical and electrophysiological study

Clinical diabetic neuropathy in childhood is rare, but electrophysiological involvement of the peripheral nerve is more frequent. We assessed clinically and electrophysiologically the peripheral nervous system of 69 children and adolescents suffering from diabetes mellitus (DM). The mean age of the patients was 12.8 years and the mean age at onset of DM was 6.8 years with a mean disease duration of 6.3 years. Seven patients (10%) had clinical neuropathy of which ankle jerk reflex abolition was the most frequent sign. Twenty patients (29%) had a neurophysiological neuropathy prevalently affecting the lower limbs. Peripheral neuropathy was correlated with patient age, older age at onset, duration of DM, height and poor glycaemic control.     

Tuberculous mesenteric lymphadenitis: a case report

The authors report a case of mesenteric tuberculous lymphadenitis which mimic a pancreatic cystadenoma. They emphasize ultrasound and CT scan features which lead to the recognition of tuberculosis and permit a percutaneous fine needle biopsy. Laparotomy seems the most reliable method for a positive diagnosis. The place of different imaging methods is discussed.     

Apigenin inhibits pancreatic cancer cell proliferation through G2/M cell cycle arrest

Background  

Many chemotherapeutic agents have been used to treat pancreatic cancer without success. Apigenin, a naturally occurring flavonoid, has been shown to inhibit growth in some cancer cell lines but has not been studied in pancreatic cancer. We hypothesized that apigenin would inhibit pancreatic cancer cell growth in vitro.     

Leptin and leptin receptor polymorphisms are associated with increased risk and poor prognosis of breast carcinoma

Background  

Leptin (LEP) has been consistently associated with angiogenesis and tumor growth. Leptin exerts its physiological action through its specific receptor (LEPR). We have investigated whether genetic variations in LEP and LEPR have implications for susceptibility to and prognosis in breast carcinoma.     

Study of overweight and obesity in a population of urban school children in Sousse, Tunisia]

AIM: The aim of this study was to assess the prevalence of obesity and overweight and their relationship with cardiovascular disease risk factors. METHODS: Epidemiological survey based on a representative sample of 1569 urban school children of Sousse, Tunisia. RESULTS: Overweight (BMI > or = 25) was significantly higher in girls (16.1%) than in boys (11.6%); (chi 2 = 8.2; p = 0.004). Obesity (BMI > or = 30) was slightly higher in girls (3.7%) than in boys (2.7%); (chi 2 = 0.89; p = 0.34). Girls had significantly higher BMI, diastolic blood pressure, cholesterol and HDL cholesterol levels than boys who had however significantly higher levels of systolic blood pressure. Overweight was significantly higher in children who did not practice sport at school: 22 versus 13.1% (p < 0.002), in groups of youngsters who were not affiliated to school sport or city associations. Overweight children had a significantly higher levels of cholesterol, HDL cholesterol and means of systolic and diastolic blood pressures. CONCLUSION: These results will serve to set up a regional program of health promotion at schools.