Solid versus liquid pulmonary micro-aspiration of reflux disease. Does it make a difference in determining the need for intervention?

Background: Pulmonary micro-aspiration (PMA) is a feared complication of gastroesophageal reflux disease (GORD). A novel scintigraphic test for GORD has been developed and validated. It can demonstrate contamination of the upper and lower airways by refluxate.

Extensive lymphadenectomy may improve survival in node negative oesophageal cancer.

Lymph node metastases are a major prognostic factor in survival of patients with oesophageal cancer. The number of lymph nodes removed during oesophagectomy has been previously proven to be associated with improved survival. The aim of this study was to examine the effect of lymph node harvest on survival specifically in pathologically node negative (pN0) patients with oesophageal cancer.

Revision Surgery is Possible in Patients With Previous Bovine Pericardium Inferior Vena Cava Reconstruction: A Case Series and Review of Literature.

There is a paucity of research investigating revision surgery for patients with previous inferior vena cava (IVC) reconstruction using bovine pericardium (BP). To the best of our knowledge, no reports of redo procedures have been published in the medical literature. We describe two cases of redo surgery in patients with previous IVC reconstructions using BP following disease recurrence.

Innovation in surgery.

The process of innovation is always valuable and can lead to great advances, both intended and unanticipated. However, the outcomes must always be carefully examined in terms of metric which considers more than could ever be tested in a RCT.

Dyspnoea improves following composite repair of giant paraoesophageal hernia.

Introduction: Paraoesophageal hernias (PEH) are often symptomatic and can lead to life-threatening complications such as volvulus and ischaemia. Dyspnoea is one of the most prevalent symptoms of giant hiatus herniae. The primary outcome of this study is resolution of dyspnoea following composite repair of giant paraoesophageal hernia.

Clinicopathologic and survival differences between adenocarcinoma of the distal oesophagus and gastro-oesophageal junction.

Background: The incidence of adenocarcinoma of the distal oesophagus (DO) and gastro-oesophageal junction (GOJ) are increasing. They may represent differing disease processes. This study aimed to assess clinicopathological and survival differences between patients with DO and GOJ adenocarcinomas.

Different clinical symptom patterns in patients with reflux micro-aspiration.

Background: Pulmonary manifestation of gastro-oesophageal reflux disease (GORD) is a well-recognised entity; however, little primary reported data exists on presenting symptoms of patients in whom reflux micro-aspiration is confirmed. The aim of this study is to report symptoms and presenting patterns of a large group of patients with confirmed reflux micro-aspiration.

Patients And Methods: Data was extracted from a prospectively populated database of patients referred to a tertiary specialist centre with severe, refractory or atypical reflux.

Internal morphology of 101 mandibular canines of a Swiss-German population by means of micro-CT: An ex vivo study.

The aim of this study was to investigate the root canal system morphology by means of a root canal configuration (RCC) classification described with a four-digit system, the physiological foramen geometry and accessory canal frequency and morphology, of 101 mandibular canines (MaCa) of a Swiss-German population by means of micro-computed tomography. Micro-CT examination of the MaCa was performed and the obtained images analyzed with a 3D imaging software. In single-rooted MaCas, the most frequently observed RCCs were 1-1-1/1 (74.

Counteracting age-related VEGF signaling insufficiency promotes healthy aging and extends life span.

Aging is an established risk factor for vascular diseases, but vascular aging itself may contribute to the progressive deterioration of organ function. Here, we show in aged mice that vascular endothelial growth factor (VEGF) signaling insufficiency, which is caused by increased production of decoy receptors, may drive physiological aging across multiple organ systems. Increasing VEGF signaling prevented age-associated capillary loss, improved organ perfusion and function, and extended life span.

A new diagnostic paradigm for laryngopharyngeal reflux disease: correlation of impedance-pH monitoring and digital reflux scintigraphy results.

Purpose: No gold-standard investigation exists for laryngopharyngeal reflux (LPR). Multichannel intraluminal impedance (MII)-pH testing has uncertain utility in LPR. Meanwhile, reflux scintigraphy allows immediate and delayed visualisation of tracer reflux in the esophagus, pharynx, and lungs.

Reflux Aspiration Associated with Oesophageal Dysmotility but Not Delayed Liquid Gastric Emptying.

Introduction: Severe oesophageal dysmotility is associated with treatment-resistant reflux and pulmonary reflux aspiration. Delayed solid gastric emptying has been associated with oesophageal dysmotility; however, the role of delayed liquid gastric emptying (LGE) in the pathophysiology of severe reflux disease remains unknown. The purpose of this study is to examine the relationship between delayed LGE, reflux aspiration, and oesophageal dysmotility.

VEGF-B Promotes Endocardium-Derived Coronary Vessel Development and Cardiac Regeneration.

Background: Recent discoveries have indicated that, in the developing heart, sinus venosus and endocardium provide major sources of endothelium for coronary vessel growth that supports the expanding myocardium. Here we set out to study the origin of the coronary vessels that develop in response to vascular endothelial growth factor B (VEGF-B) in the heart and the effect of VEGF-B on recovery from myocardial infarction.

Methods: We used mice and rats expressing a VEGF-B transgene, VEGF-B-gene-deleted mice and rats, apelin-CreERT, and natriuretic peptide receptor 3-CreERT recombinase-mediated genetic cell lineage tracing and viral vector-mediated VEGF-B gene transfer in adult mice.

Does composite repair of giant paraoesophageal hernia improve patient outcomes?

Background: Paraoesophageal hernia (PEH) is often symptomatic and reduces patients' quality of life (QoL). There is ongoing debate regarding the most effective surgical technique to repair giant PEH. This study aimed to see if an elective laparoscopic non-mesh composite technique of giant PEH repair offered an advantage in symptom control, hernia recurrence, QoL, morbidity and mortality.

Innovative high-resolution microCT imaging of animal brain vasculature.

Analysis of the angioarchitecture and quantification of the conduit vessels and microvasculature is of paramount importance for understanding the physiological and pathological processes within the central nervous system (CNS). Most of the available in vivo imaging methods lack penetration depth and/or resolution. Some ex vivo methods may provide better resolution, but are mainly destructive, as they are designed for imaging the CNS tissues after their removal from the skull or vertebral column.

Predictors of reflux aspiration and laryngo-pharyngeal reflux.

Background: Gastro-esophageal reflux disease (GERD) can present with typical or atypical or laryngo-pharyngeal reflux (LPR) symptoms. Pulmonary aspiration of gastric refluxate is one of the most serious variants of reflux disease as its complications are difficult to diagnose and treat. The aim of this study was to establish predictors of pulmonary aspiration and LPR symptoms.

Adaptation mechanism of the adult zebrafish respiratory organ to endurance training.

In order to study the adaptation scope of the fish respiratory organ and the O2 metabolism due to endurance training, we subjected adult zebrafish (Danio rerio) to endurance exercise for 5 weeks. After the training period, the swimmer group showed a significant increase in swimming performance, body weight and length. In scanning electron microscopy of the gills, the average length of centrally located primary filaments appeared significantly longer in the swimmer than in the non-trained control group (+6.

Is repairing giant hiatal hernia in patients over 80 worth the risk?

Patients with giant hiatal hernia (GHH) are often symptomatic and have significantly reduced quality of life (QoL). Advanced age is a predictor of increased morbidity and mortality in open hiatal surgery, however, outcomes of laparoscopic surgery in patients over the age of 80 are limited to case reports and small case series. Data was extracted from a prospectively maintained database.

Forgotten Elastic Band as an Unusual Cause of Limb Ulceration: Case Report and Review of the Literature.

We discuss a case of circumferential ulceration of the lower leg in a cognitively impaired elderly man with poor tissue integrity. Thorough clinical examination eventually determined the cause as being a circumferentially placed, forgotten elastic band causing ulceration via sustained tension around the limb. Circumferential application of an elastic band to an extremity is an exceedingly rare but serious cause of lower leg ulceration.

Gastro-Oesophageal Reflux and Aspiration: Does Laparoscopic Fundoplication Significantly Decrease Pulmonary Aspiration?

Purpose: Pulmonary aspiration of gastric refluxate is one of the indications for anti-reflux surgery. Effectiveness of surgery in preventing pulmonary aspiration post-operatively has not been previously tested. The aim of this project is to assess effectiveness of anti-reflux surgery on preventing pulmonary aspiration of gastric refluxate.

Cutting-edge microangio-CT: new dimensions in vascular imaging and kidney morphometry.

In the last decades, the contrast-enhanced micro-computed tomography (micro-CT) imaging of a whole animal kidney became increasingly important. The visualization was mainly limited to middle-sized vessels. Since modern desktop micro-CT scanners provide the necessary detail resolution, we developed an approach for rapid visualization and consistent assessment of kidney vasculature and glomeruli number.

Gastrointestinal tract obstruction secondary to post-operative oedema: does dexamethasone administration help?

Oedema can occur in handled tissues following upper gastrointestinal surgery with anastomosis formation. Obstruction of the lumen may result in delayed return of enteric function. Intravenous steroid use may be beneficial.

Case report: Renal infarction by paradoxical embolism through the patent foramen ovale as an unusual cause of post-operative abdominal pain after sleeve gastrectomy.

50-year-old female presented with abdominal pain 9days post sleeve gastrectomy and was found to have acute renal infarction caused by paradoxical emboli through patent foramen ovale (PFO) as a cause of the renal infarction. Renal infarctions caused by paradoxical embolism are rare and have not been previously reported following surgery, bariatric surgery in particular. This report describes presentation, work up and management of a patient with renal infarct following bariatric surgery.

[Dynamics of ischemic skeletal soleus muscle contraction in rats].

The processes of change in the rate of generation of power response of artificially ischemic muscle using frequency modulated electrical efferent stimulation were investigated. A strain-gauge technique for registration of contraction process was used. Ischemia was induced by ligating main blood vessels of lower extremity.