Regulation of nerve growth and patterning by cell surface protein disulphide isomerase.

Contact repulsion of growing axons is an essential mechanism for spinal nerve patterning. In birds and mammals the embryonic somites generate a linear series of impenetrable barriers, forcing axon growth cones to traverse one half of each somite as they extend towards their body targets. This study shows that protein disulphide isomerase provides a key component of these barriers, mediating contact repulsion at the cell surface in chick half-somites.

The mass effect of a slowly growing GIST.

Gastrointestinal stromal tumours (GISTs) are typically defined as solid masses arising from the GI tract, most commonly from the stomach and small intestine. They seldom present in a cystic form. Management of cystic masses arising from the GI tract may pose a diagnostic predicament.

Acute gastric outlet obstruction secondary to exclusive paraoesophageal small bowel herniation: a case report.

Introduction: Herniation of abdominal viscera into the thorax may occur as a consequence of abnormal defects in the diaphragm. In adults, the most common condition relates to herniations through a weakened crural orifice via which the oesophagus normally traverses. These hiatus hernias are classified as types I-IV depending on the extent of visceral involvement.

Common variants at the MHC locus and at chromosome 16q24.1 predispose to Barrett's esophagus.

Barrett's esophagus is an increasingly common disease that is strongly associated with reflux of stomach acid and usually a hiatus hernia, and it strongly predisposes to esophageal adenocarcinoma (EAC), a tumor with a very poor prognosis. We report the first genome-wide association study on Barrett's esophagus, comprising 1,852 UK cases and 5,172 UK controls in the discovery stage and 5,986 cases and 12,825 controls in the replication stage. Variants at two loci were associated with disease risk: chromosome 6p21, rs9257809 (Pcombined=4.

Transthoracic repair of an incarcerated diaphragmatic hernia using hexamethylene diisocyanate cross-linked porcine dermal collagen (Permacol).

It is the general surgeon who commonly repairs paraesophageal hernias nowadays, and they are repaired laparoscopically, making the performance of thoracotomy relatively rare. Whether to use prosthetic materials to repair the hiatus is still under debate, as is the question of which material to use, if any. We report a case of a 38-year-old man who had a large, incarcerated paraesophageal hernia.

The decision to operate: role of integrated computed tomography positron emission tomography in staging oesophageal and oesophagogastric junction cancer by the multidisciplinary team.

Objective: Our objective was to assess the role of fusion positron emission tomography-computed tomography (PET-CT) in staging patients for minimally invasive oesophagectomy (MIO) with potentially resectable disease from the perspective of a multidisciplinary team (MDT) deciding on operability with conventional staging investigations.

Methods: Fifty consecutive patients presenting with potentially operable oesophageal or oesophagogastric junctional tumours were staged with computed tomography (CT) and endoluminal ultrasound (EUS). The MDT categorised patients as group A (n=33; CT N0M0) or group B (n=17; CT N1/possible M1).

Transgastric drainage of the oesophagus: managing difficult oesophageal injuries.

We describe a technique for maintaining patency of the injured or repaired oesophagus while providing vacuum drainage of the oesophageal lumen. A small midline laparotomy is performed. A lubricated 36F soft chest drain (pull-through end) is introduced into the oesophagus using a percutaneous endoscopic gastrostomy (PEG) set, and pulled out through the stomach wall.