Cost-Effective Restrictive Bariatric Surgery: Laparoscopic Vertical Banded Gastroplasty Versus Laparoscopic Adjustable Gastric Band

Background  

Among bariatric restrictive operations, the procedure of choice is still controversial. The aim of this study is to compare the cost of two gastric restrictive procedures: laparoscopic vertical banded gastroplasty (LVBG) and laparoscopic adjustable gastric banding (LAGB).     

Non-coronary cardiac events,younger age,and IVIG unresponsiveness increase the risk for coronary aneurysms in Italian children with Kawasaki disease

Clinical Rheumatology - Kawasaki disease (KD) is the most frequent cause of acquired heart disease in children in high-income countries because of coronary artery involvement. Risk factors for...     

Multicenter long-term results of antitachycardia pacing for supraventricular tachycardias

This report describes the multicenter experience of the Tachylog antitachycardia pacemaker (Siemens-Elema) in the treatment of drug-refractory, recurrent supraventricular arrhythmias. The device has been implanted in 63 patients (mean age 47 years). The arrhythmias were atrial tachycardia in 4 patients (6%), atrioventricular nodal reentry tachycardia in 23 patients (37%), circus movement tachycardia via an overt bypass tract in 17 patients (27%) and via a concealed bypass tract in 19 patients (30%). The mean follow-up period was 30 months. In 28 patients (44%) arrhythmia control was achieved with the pacemaker therapy alone. In 31 patients (49%) drug therapy had to be reintroduced to obtain control of recurrent arrhythmias. Four patients (6%) were definite nonresponders. In 4 patients (6%) the pulse generator was explanted either because it was not tolerated or because of tachycardia-sensing failure. No syncope or death was observed during follow-up. Thus, antitachycardia pacing gives satisfactory results in selected patients with drug-refractory supraventricular tachycardias.     

Outbreak of tuberculosis in a migrants' shelter, Paris, France, 2002.

SETTING: An overcrowded 362-bed migrants' shelter in Paris, France. OBJECTIVES: To investigate an outbreak of tuberculosis (TB), to identify a common source of contamination and to prevent further transmission. METHODS: The outbreak was identified by radiographic screening and an active search for undeclared hospital treated cases, completed by strain phenotyping and a search for contact cases. RESULTS: Between October 2001 and October 2002, 56 cases of active TB were identified, 30 by radiological screening and 20 by contacting neighbouring hospitals. All cases involved men, with a median age of 30 years. Pulmonary involvement was present in 54% of cases, and nine patients were sputum smear-positive. Thirty-four of the 37 phenotyped strains clustered together. CONCLUSION: The grouping of the cases in time and place, the large number of cases with early-stage disease and the identical RFLP banding patterns of most of the isolates indicate that this outbreak results from transmission that occurred in France. This report underlines the need for public health departments in industrialised countries to maintain effective anti-tuberculosis control programmes.     

Aberrant accrual of BIN1 near Alzheimer’s disease amyloid deposits in transgenic models

Bridging integrator 1 (BIN1) is the most significant late‐onset Alzheimer’s disease (AD) susceptibility locus identified via genome‐wide association studies. BIN1 is an adaptor protein that regulates membrane dynamics in the context of endocytosis and membrane remodeling. An increase in BIN1 expression and changes in the relative levels of alternatively spliced BIN1 isoforms have been reported in the brains of patients with AD. BIN1 can bind to Tau, and an increase in BIN1 expression correlates with Tau pathology. In contrast, the loss of BIN1 expression in cultured cells elevates Aβ production and Tau propagation by insfluencing endocytosis and recycling. Here, we show that BIN1 accumulates adjacent to amyloid deposits in vivo. We found an increase in insoluble BIN1 and a striking accrual of BIN1 within and near amyloid deposits in the brains of multiple transgenic models of AD. The peri‐deposit aberrant BIN1 localization was conspicuously different from the accumulation of APP and BACE1 within dystrophic neurites. Although BIN1 is highly expressed in mature oligodendrocytes, BIN1 association with amyloid deposits occurred in the absence of the accretion of other oligodendrocyte or myelin proteins. Finally, super‐resolution microscopy and immunogold electron microscopy analyses highlight the presence of BIN1 in proximity to amyloid fibrils at the edges of amyloid deposits. These results reveal the aberrant accumulation of BIN1 is a feature associated with AD amyloid pathology. Our findings suggest a potential role for BIN1 in extracellular Aβ deposition in vivo that is distinct from its well‐characterized function as an adaptor protein in endocytosis and membrane remodeling.     

Ultraviolet responses of Gorlin syndrome primary skin cells

Background  Gorlin syndrome, or naevoid basal cell carcinoma syndrome (NBCCS), is an autosomal dominant disorder associated with mutations in the PTCH1 gene, which encodes the receptor of SONIC HEDGEHOG. In addition to developmental abnormalities, patients with NBCCS are prone to basal cell carcinoma (BCC), the most frequent type of nonmelanoma skin cancer in humans.
Objectives  As ultraviolet (UV) exposure plays a prominent role in the development of sporadic BCC, we aimed to determine whether primary NBCCS skin cells exhibit differential responses to UV exposure compared with wild-type (WT) skin cells.
Methods  Primary fibroblast and keratinocyte strains were isolated from nonlesional skin biopsies of 10 patients with characteristic NBCCS traits. After identification of PTCH1 mutations, capacities of NBCCS cells to repair UV-induced DNA lesions and to survive after UV irradiation, as well as p53 responses, were compared with those of WT skin cells.
Results  The c1763insG PTCH1 mutation is described for the first time. DNA repair and cell survival analyses following UV irradiation revealed no obvious differences between responses of NBCCS and WT fibroblasts and keratinocytes. However, p53 accumulation after UV irradiation was abnormally persistent in all NBCCS primary keratinocyte strains compared with WT keratinocytes.
Conclusions  Our observations that NBCCS cells harbour normal DNA repair and survival capacities following UV irradiation better explain that BCC proneness of patients with NBCCS does not solely concern body areas exposed to sunlight and suggest rather that it might be due to cell cycle alterations.