Should We Operate Nonagenarians with Symptomatic Giant Paraesophageal Hernias?

Hiatal hernia (HH) is a common disorder of the upper gastrointestinal (UGI) tract that general surgeons encounter. Giant paraesophageal is a subtype of HH in which more than 30% of the stomach is located in the chest. It can cause symptoms such as dysphagia, UGI bleeding, gastroesophageal reflux disease, and vomiting.

Robotic Heller's myotomy using the new Hugo™ RAS system: first worldwide report.

Background: Achalasia is a rare disorder of the esophagus characterized by motor dysfunction in the esophagus and relaxation failure of the lower esophageal sphincter (LES). Currently, surgical myotomy procedures are considered the standard of care. Robotic Heller's myotomy (RHM) with fundoplication has been gaining popularity due to documented advantages in the precision of myotomy as well as avoiding the potential reflux following per-oral endoscopic myotomy (POEM).

Changes in neural readout of response magnitude during auditory streaming do not correlate with behavioral choice in the auditory cortex.

A fundamental goal of the auditory system is to group stimuli from the auditory environment into a perceptual unit (i.e., "stream") or segregate the stimuli into multiple different streams.

Laminar neural dynamics of auditory evoked responses: Computational modeling of local field potentials in auditory cortex of non-human primates.

Evoked neural responses to sensory stimuli have been extensively investigated in humans and animal models both to enhance our understanding of brain function and to aid in clinical diagnosis of neurological and neuropsychiatric conditions. Recording and imaging techniques such as electroencephalography (EEG), magnetoencephalography (MEG), local field potentials (LFPs), and calcium imaging provide complementary information about different aspects of brain activity at different spatial and temporal scales. Modeling and simulations provide a way to integrate these different types of information to clarify underlying neural mechanisms.

The Angle of His as a Measurable Element of the Anti-reflux Mechanism.

Background: Gastroesophageal reflux disease (GERD) is a common condition, resulting from the loss of the anti-reflux barrier. Laparoscopic fundoplication is the surgical procedure of choice for treatment of GERD; however, there remains a debate on the exact mechanism through which it prevents reflux.

Objectives: Our aim was to understand the relationship between reflux, fundoplication, and the angle of His on an experimental model.