Laparoscopic Conversion of Gastric Bypass to Distal Gastric Bypass for Inadequate Weight Loss.

Background: Although uncommon, significant weight recurrence after Roux-en-Y gastric bypass (RYGB) can occur. Options are limited to help patients achieve additional weight loss, and improved techniques for revisional/conversional surgery are needed to achieve optimal outcomes while avoiding significant side effects. Although limited data exist regarding distalization of the Roux limb to achieve a longer biliopancreatic limb leading to some level of malabsorption, we have seen adequate weight loss with minimal significant side effects in patients undergoing this procedure with our approach.

Examination of abdominal wall perfusion using varying suture techniques for midline abdominal laparotomy closure.

Background: With a growing interest in the primary prevention of incisional hernias, it has been hypothesized that different suturing techniques may cause various levels of tissue ischemia. Using ICG laser-induced fluorescence angiography (ICG-FA), we studied the effect of different suture materials and closure techniques on abdominal wall perfusion.

Methods: Fifteen porcine subjects underwent midline laparotomy, bilateral skin flap creation, and three separate 7 cm midline fascial incisions.

Robotic Approach to Paraesophageal Hernia Repair Results in Low Long-Term Recurrence Rate and Beneficial Patient-Centered Outcomes.

Background: Little is known regarding important long-term outcomes after robotic paraesophageal hernia (PEH) repairs, such as symptom relief and recurrence rates. The aim of this study was to evaluate the long-term clinical outcomes in a large series of patients undergoing robotic PEH repair.

Study Design: This prospective, IRB-approved study analyzed adult patients who underwent robotic PEH repair, from 2010 to 2014, at a high-volume tertiary academic medical center.

Favorable peri-operative outcomes observed in paraesophageal hernia repair with robotic approach.

Background: The robotic surgical approach offers enhanced visualization, dexterity and reach, which may facilitate the more technically demanding portions of paraesophageal hernia (PEH) repair such as hiatal reconstruction and mediastinal dissection. We sought to compare the peri-operative clinical outcomes of the laparoscopic vs. robotic approach to PEH repair.

The impact of internet-based patient self-education of surgical mesh on patient attitudes and healthcare decisions prior to hernia surgery.

Background: As internet access improves, patient self-education continues to increase. However, patient surgical background, e-literacy, and media exposure potentially influence what information patients search online. This impacts patient concern, healthcare decisions, and subsequent patient-physician interactions.

Modulation of NKG2D, NKp46, and Ly49C/I facilitates natural killer cell-mediated control of lung cancer.

Natural killer (NK) cells play a critical role in controlling malignancies. Susceptibility or resistance to lung cancer, for example, specifically depends on NK cell function. Nevertheless, intrinsic factors that control NK cell-mediated clearance of lung cancer are unknown.

Mechanisms of Graft Rejection and Immune Regulation after Lung Transplant.

Outcomes after lung transplant lag behind those of other solid-organ transplants. A better understanding of the pathways that contribute to rejection and tolerance after lung transplant will be required to develop new therapeutic strategies that take into account the unique immunological features of lungs. Mechanistic immunological investigations in an orthotopic transplant model in the mouse have shed new light on immune responses after lung transplant.

Deficiency of the adaptor protein SLy1 results in a natural killer cell ribosomopathy affecting tumor clearance.

Individuals with robust natural killer (NK) cell function incur lower rates of malignancies. To expand our understanding of genetic factors contributing to this phenomenon, we analyzed NK cells from cancer resistant and susceptible strains of mice. We identified a correlation between NK levels of the X-chromosome-located adaptor protein SLy1 and immunologic susceptibility to cancer.

Retrograde Intrarenal Surgery Versus Shock Wave Lithotripsy for Renal Stones Smaller Than 2 cm: A Randomized Clinical Trial.

Purpose: To compare outcomes of retrograde intrarenal surgery (RIRS) with extracorporeal shock wave lithotripsy (SWL) for stones ≤ 2 cm.

Materials And Methods: Patients who were diagnosed with kidney stones of ≤ 2 cm underwent RIRS or SWL in a parallel group randomized clinical trial with balanced randomization [1:1] from 2011 to 2014. The primary outcome of interest was stone free rate after a single session intervention.

Selective targeting of IL-2 to NKG2D bearing cells for improved immunotherapy.

Despite over 20 years of clinical use, IL-2 has not fulfilled expectations as a safe and effective form of tumour immunotherapy. Expression of the high affinity IL-2Rα chain on regulatory T cells mitigates the anti-tumour immune response and its expression on vascular endothelium is responsible for life threatening complications such as diffuse capillary leak and pulmonary oedema. Here we describe the development of a recombinant fusion protein comprised of a cowpox virus encoded NKG2D binding protein (OMCP) and a mutated form of IL-2 with poor affinity for IL-2Rα.

Evaluation of factors impacting cosmetic outcome of breast conservative surgery--a study in Iran.

Background: Breast conservative surgery (BCS) followed by radiotherapy is the standard approach in management of stage I-II breast cancer. Several factors can affect cosmetic outcomes. The aim of this study was to evaluate the cosmetic results of BCS and influencing factors in the Iranian Breast Cancer Research Center.

Osteoid osteoma of the rib presenting as thoracic outlet syndrome.

Osteoid osteoma of the rib is a rare condition mostly mentioned in case report studies as lesions involving posterior region of the rib causing scoliosis. This report presents a 22-year-old man who complained of neurologic thoracic outlet syndrome symptoms. The pathologic study of the resected mass of the first rib confirmed the diagnosis of osteoid osteoma.

Adult acute calcific discitis confined to the nucleus pulposus in the cervical spine: case report.

Acute calcific discitis is a rare condition in the pediatric population and has been reported in only 2 instances in the adult population. This report describes a case of acute calcific discitis that uniquely presented in the adult cervical spine. A 22-year-old woman presented with the chief complaint of sudden-onset neck pain.

Effects of laparoscopic Roux-en-Y gastric bypass (LRYGB) on weight loss and biomarker parameters in morbidly obese patients: a 12-month follow-up.

Background: Laparoscopic Roux-en-Y gastric bypass (LRYGB) is suggested as the gold standard of the surgical techniques for morbid obesity treatment. The aim of this study was to evaluate the weight loss and biomarker parameter changes over a 1-year period following LRYGB in Iranian morbidly obese patients.

Methods: Sixty patients who had undergone LRYGB from June 2006 to August 2008 were followed up.

Laparoscopic versus open appendectomy; which method to choose? A prospective randomized comparison.

Appendicitis is the most common surgical emergency with the incidence rate of 6-10%. Although several studies have compared the two approaches of open (OA) and laparoscopic appendectomy (LA) the technique of choice is still a matter of controversy. Considering this background we designed a study to compare OA and LA outcomes in our center.