A decade's review for membrane anatomy: the setting,events in it, order formed by primary fascia and serous membrane / 中华胃肠外科杂志

The successful report of total mesorectal excision (TME)/complete mesocolic excision (CME) has encouraged people to apply this concept beyond colorectal surgery. However, the negative results of the JCOG1001 trial denied the effect of complete resection of the "mesogastrium" including the greater omentum on the oncological survival of gastric cancer patients. People even believe that the mesentery is unique in the intestine, because they have a vague understanding of the structure of the mesentery. The discovery of proximal segment of the dorsal mesogastrium (PSDM) proved that the greater omentum is not the mesogastrium, and further revised the structure (definition) of the mesentery and revealed its container characteristics, i.e. the mesentery is an envelope-like structure, which is formed by the primary fascia (and serosa) that enclose the tissue/organ/system and its feeding structures, leading to and suspended on the posterior wall of the body. Breakdown of this structure leads to the simultaneous reduction of surgical and oncological effects of surgery. People quickly realized the universality of this structure and causality which cannot be matched by the existing theories of organ anatomy and vascular anatomy, so a new theory and surgical map- membrane anatomy began to form, which led to radical surgery upgraded from histological en bloc resection to anatomic en bloc resection.

Scientific paradigm of membrane anatomy / 中华胃肠外科杂志

Anatomical plane and fascia have been described in medical behaviors for hundreds of years since the appearance of anatomy and operation. Generally, these descriptions can be sorted into three theories, i.e. plane surgery, fascia theory and mesentery anatomy. However, these theories are difficult to satisfy the scientific paradigm that includes consistency in description, independence in validation, potential to solve practical problems, and the interaction of the above-mentioned theries. Recently, membrane anatomy was proposed as the anatomy of mesentery and its beds in broad sense. Behind it lies fascia membrane/serous membrane structure, as well as inherent life events and general order. Mesentery in broad sense is described as the fascia membrane/serous membrane in serous cavity, which envelops and suspends the organ/tissue and its feeding structures to the posterior wall of the body. Anatomy is the setting/structure, in which life events/functions occur. In the research and discussion of membrane anatomy, abiding by the scientific paradigm and upholding the scientific spirit are the only way to obtain reliable knowledge and the criterion for in-depth scientific research.

Placenta percreta com invasão de bexiga: um relato de caso / Percretal placenta with bladder invasion: a case report

O acretismo placentário consiste na aderência anormal da placenta na parede uterina. Ao aderir-se diretamente ao miométrio, denomina-se placenta acreta; ao estender-se mais profundamente, placenta increta, e ao invadir a serosa uterina ou órgãos adjacentes, percreta. O fator de risco mais frequente constitui cesarianas anteriores. Paciente 27 anos, G3P1CA1 (cesariana há 8 anos/ parto prematuro 25 sem há 4 anos), IG: 25sem3d; com alteração da vitalidade fetal e placenta prévia com sinais de acretismo (sugerindo placenta percreta). Foi indicada a interrupção da gestação com 27 semanas e 1 dia. No período intraoperatório foi evidenciada, por meio de ultrassom, presença de acretismo placentário com invasão miometrial e invasão de serosa vesical sendo posteriormente realizado a histerectomia subtotal e rafia das lacerações da mucosa vesical. A placenta percreta é mais frequente em grávidas com placenta prévia no local da cicatriz de cesariana e o órgão mais frequentemente acometido é a bexiga; estando associada a maior morbimortalidade materna. O diagnóstico definitivo é anatomopatológico, porém é presumível durante a cirurgia abdominal com a visualização da invasão placentária, devendo ser confirmado por Histopatologia.

Placental accretism consists of abnormal placental adherence to the uterine wall. When adhering directly to the myometrium it is called placenta accreta; when extending more deeply, placenta increta; and when invading the uterine serosa or adjacent organs, percrete. The most frequent risk factor is previous cesarean sections. The patient is 27 years old with altered fetal vitality and placenta previa with signs of accreation (suggesting percretal placenta). Pregnancy termination at 27 weeks and one day was indicated. In the intraoperative period, the presence of placental accretion with myometrial invasion and bladder serous invasion was evidenced by ultrasound, with subtotal hysterectomy and raffia of lacerations of the bladder afterwards. The percretal placenta is more frequent in pregnant women with placenta previa at the site of the scar of a cesarean section and the organ most frequently affected is the bladder; being associated with higher maternal morbidity and mortality. The definitive diagnosis is anatomopathological, but it is presumed during abdominal surgery with the visualization of the placental invasion and must be confirmed by Histopathology

Xenarthras: topografia intestinal e relações vasculares com a serosa / [Xenarthras: intestinal topography and vascular relationships with serosa]

Xenarthras (Mammalia, Dasypodidae) das espécies Dasypus novemcinctus e Euphractus sexcinctus tiveram sua anatomia científica estudada em relação à topografia dos intestinos delgado e grosso, suas relações peritoniais, morfologia externa e irrigação. Medidas dos diferentes segmentos intestinais e do número de vasos a eles destinados foram tomadas para fins comparativos. O método previu: fixação (formol 7%); injeção de látex; dissecação e fotodocumentação. Espacialmente, embora os intestinos sejam fixados por dupla membrana peritoneal, como em outros vertebrados, nestes a serosa conectou o duodeno, o jejuno, o íleo e os cólons em um único ligamento fixado no dorso do animal. Duodeno e pâncreas, intraperitoniais, como o reto, fixaram-se nas pelves maior e menor, respectivamente e dorsalmente. Vasos derivados do tronco celíaco mesentérico e da aorta percorreram o interior do mesoduodeno, do mesentério comum, do mesocólon e do mesorreto, estando estes, ao longo de seus trajetos, relacionados às cadeias linfonodulares intestinais. O modelo de rotação peritoneal, a morfologia externa, bem como o modelo de vascularização intestinal, foram interpretados como basais, diferindo dos vertebrados recentes, conforme o suporte literário.(AU)

Xenarthras (Mammalia, Dasypodidae) of the species Dasypus novemcinctus and Euphractus sexcinctus had their scientific anatomy studied in relation to the topography of the small and large intestines, their peritoneal relationships, external morphology and irrigation. Measurements of the different intestinal segments and the number of vessels destined for them were taken for comparative purposes. The method predicted: fixation (7% formaldehyde); latex injection; dissection and photo documentation. Spatially, the intestines, although fixed by a double peritoneal membrane, as in other vertebrates, in these, the serosa connected the duodenum, jejunum, ileum, and the colon in a single ligament fixed to the animal's back. Duodenum and pancreas, intraperitoneal, like the rectum, were fixed in the major and minor pelvis respectively and dorsally. Vessels derived from the mesenteric celiac trunk and the aorta traveled through the interior of the mesoduodenum, common mesentery, mesocolon and mesoride, being related to the lymph node chains along their pathways. The peritoneal rotation model, the external morphology as well as the model of intestinal vascularization were interpreted as basal, differing from recent vertebrates, according to literary support.(AU)

High-resolution Mapping of Hyperglycemia-induced Gastric Slow Wave Dysrhythmias

BACKGROUND/AIMS: It is now recognised that gastric dysrhythmias are best characterised by their spatial propagation pattern. Hyperglycemia is an important cause of gastric slow wave dysrhythmia, however, the spatiotemporal patterns of dysrhythmias in this context have not been investigated. This study aims to investigate the relationship between hyperglycemia and the patterns of dysrhythmias by employing high-resolution (multi-electrode) mapping simultaneously at the anterior and posterior gastric serosa. METHODS: High-resolution mapping (8 × 16 electrodes per serosal) was performed in 4 anesthetized hounds. Baseline recordings (21 ± 8 minutes) were followed by intravenous injection of glucagon (0.5 mg per dose) and further recordings (59 ± 15 minutes). Blood glucose levels were monitored manually using a glucose sensing kit at regular 5-minute intervals. Slow wave activation maps, amplitudes, velocity, anisotropic ratio, and frequency were calculated. Differences were compared between baseline and post glucagon injection. RESULTS: Baseline slow waves propagated symmetrically and antegrade. The blood glucose levels were increased by an average of 112% compared to the baseline by the end of the recordings. All subjects demonstrated elevated incidence of slow wave dysrhythmias following injection compared to the baseline (48 ± 23% vs 6 ± 4%, P < 0.05). Dysrhythmias arose simultaneously or independently on anterior and posterior serosa. Spatial dysrhythmias occurred before and persisted after the onset and disappearance of temporal dysrhythmias. CONCLUSIONS: Infusion of glucagon induced gastric slow wave dysrhythmias, which occurred across a heterogeneous range of patterns and frequencies. The spatial dysrhythmias of gastric slow waves were shown to be more prevalent and persisted over a longer period of time compared to the temporal dysrhythmias.

Remnant parietal serosa detection in a cat with true diaphragmatic hernia using computed tomography / 대한수의학회지

A 4-year-old cat was referred for a suspected pulmonary mass. True diaphragmatic hernia presence was diagnosed via computed tomography (CT). There was a thin membrane covering the diaphragmatic defect. The membrane was thinner than the diaphragm. After contrast injection, the membrane was less enhanced than that of the normal diaphragm. The membrane was identified as a remnant of the parietal pleura. In addition, contrast-enhanced CT images provided clarity in viewing the herniated liver and falciform fat. A thinner membrane, covering the diaphragmatic defect, and attached to the thicker normal diaphragm, is considered a unique CT feature of true diaphragmatic hernia.

Cáncer de endometrio: reporte de un caso y revisión de la literatura / Endometrial Cancer. Case report and literature review

Antecedentes: El cáncer endometrial (CE) según las estadísticas es el tumor ginecológico más frecuente en países desarrollados, donde su incidencia ha ido en aumento. Históricamente, el CE se ha clasificado en dos tipos: Tipo I (endometrioide), representando el 80-90% de los casos; el tipo II (no endometrioide como el de células serosas y claras, carcinomas indiferenciados). Como dato importante, la mayoría de las pacientes son diagnosticadas cuando la enfermedad se encuentra en etapas tempranas o la lesión todavía está confinada al útero. El tratamiento convencional radica en una histerectomía primaria más salpingooforectomía bilateral, según el estadío de la enfermedad. Caso clínico: Paciente de 58 años de edad que ingresa al Hospital de San Marcos, Ocotepeque, con sangrado transvaginal de 1 mes de evolución, hipertensión crónica y obesidad tipo I. En el ultrasonido transvaginal se observó engrosamiento endometrial, pero en la biopsia se diagnosticó Adenocarcinoma Endometrial de tipo Endometroide Grado II-III de la FIGO. Conclusión: Ante la presencia de sangrado uterino anormal en mujeres peri y postmenopáusicas, con factores de riesgos asociados, se debe sospechar cáncer de endometrio...(AU)

Sudden death caused by trichlorfon poisoning in Korean native cattle / 대한수의학회지

Two 12-month-old cattle with anthelmintics containing trichlorfon the day before death presented to the Animal and Plant Quarantine Agency for diagnosis. In necropsy, they revealed enlargement of the spleens, redness of mucosa and serosa in stomachs and intestines, and friable kidneys. Histopathologically, hemorrhages in the spleens, omasums, abomasums, and intestines as well as renal tubular necrosis were observed. Trichlorfon was detected at above the lethal dose in the ruminal contents. Based on these findings, we diagnosed this case as death caused by trichlorfon poisoning.

Comparación del recuento celular entre un método manual y un contador automatizado en líquidos de derrame / Comparison of manual microscope method and an automated cell count in serous fluids / Comparação da recontagem celular entre um método manual e um contador automatizado em líquidos de derrame

El objetivo del trabajo consistió en comparar el recuento celular total en los líquidos de derrame de cavidades serosas entre el método automatizado empleado en hematología y el método manual en hemocitómetro. Se procesaron 107 muestras: 45 líquidos ascíticos (LA) y 62 líquidos pleurales (LP) a los que se les realizó el recuento celular en cámara de Neubauer y en contador hematológico Sysmex XT 1800i. Se obtuvieron los siguientes resultados: 1) Regresión lineal: los coeficientes de correlación indicaron una alta correlación entre ambos métodos (LA r2: 0,999; p<0,0001 y LP r2: 0,997; p<0,0001). 2) Bland-Altman: El análisis de las figuras muestra una excelente concordancia entre ambos métodos. El error sistemático fue 51 para los LA y 97 para los LP, por lo que estos valores son despreciables dado el valor diagnóstico de los datos. Los resultados demuestran que los métodos son comparables entre sí y, por ende, se puede remplazar el recuento manual por el automatizado, de demostrada eficiencia y exactitud. Sin embargo, todos los líquidos requieren una observación al microscopio óptico previa al procesamiento por el contador hematológico, donde se apreciará la presencia de agrupamientos celulares como, por ejemplo, células neoplásicas en disposición glandular que dificultan el análisis por parte del equipo o la interpretación del resultado.

The purpose of this work was to compare the total cell count in liquids serous cavities between the automated method used in hematology and the manual method hemocytometer. A total of 107 samples were processed: 45 ascites fluids (LA for its name in Spanish) and 62 pleural fluids (LP for its name in Spanish). The cells were counted in improved Neubauer counting chamber and hematology analyzer Sysmex XT 1800i. The following results were obtained: 1) Linear Regression correlation coefficients indicated a high correlation between the two methods (LA r2: 0.999; p<0.0001 LP r2: 0.997; p<0.0001). 2) Bland-Altman analysis graphics showed excellent agreement between both methods. The systematic error was 51 for LA and 97 for LP; these values are insignificant considering the diagnostic value of the data. he results demonstrate that the methods are comparable and therefore can replace the manual counting by the automated method with proven efficiency and accuracy. However, all fluids require observation by optical microscope before being processed by the hematology analyzer, where the presence of cell clusters such as neoplastic cells in glandular disposition will be appreciated, which hinder the analysis by the equipment or interpretation of results.

O objetivo do trabalho consistiu em comparar a contagem total de células em líquidos de derrame de cavidades serosas entre o método automatizado utilizado em hematologia e o método manual em hemocitômetro. Foram processadas 107 amostras: 45 líquidos ascíticos (LA) e 62 líquidos pleurais (LP) nos quais se realizou a recontagem celular na câmara de Neubauer e no contador hematológico Sysmex XT 1800i. Foram obtidos os seguintes resultados: 1) Regressão linear: os coeficientes de correlação indicaram uma alta correlação entre ambos os métodos (LA r2: 0,999; p<0,0001 e LP r2: 0,997; p<0,0001). 2) Bland-Altman: A análise dos Figuras mostra uma excelente concordância entre ambos os métodos. O erro sistemático foi 51 para os LA e 97 para os LP, resultando estes valores desprezáveis dado o valor diagnóstico dos dados. Os resultados demonstram que os métodos são comparáveis entre si e, portanto, pode ser substituída a contagem manual pela automatizada, de eficiência e exatidão demonstradas. Entretanto, todos os líquidos requerem observação no microscópio óptico prévia ao processamento pelo contador hematológico. Nesse momento se apreciará a presença de agrupamentos celulares como, por exemplo, células neoplásicas em disposição glandular que dificultam a análise por parte da equipe ou a interpretação do resultado.

Eosinophilic Gastrointestinal Disorder Presenting as Intractable Vomiting and Ascites in a Young Girl / 대한소아소화기영양학회지

Eosinophilic gastrointestinal disorder (EGID) is a rare disease in children that affects the bowel wall, with eosinophilic infiltration in the absence of any other causes for eosinophilia. The etiology remains unknown, but allergies and immunological imbalance are suspected triggers. We encountered a case of serosal EGID presenting as intractable vomiting and ascites in a 9-year-old girl, after influenza virus infection. Peripheral eosinophilia was not present. The diagnosis was confirmed by biopsy of the bowel wall through laparotomy and endoscopy, and controlled by 2 courses of steroid therapy due to recurring symptoms. Influenza virus infection was assumed to play a role in the onset of EGID through a Th2 response that stimulated eosinophilic infiltration in the GI tract. We therefore report this case along with a literature review.

Successful laparoscopic management of uterine serosal pregnancy

Uterine serosal pregnancy is an extremely rare form of ectopic pregnancy. This is a report of a 35-year-old primigravida woman who was diagnosed with uterine serosal pregnancy via laparoscopic intervention. A 35-year-old woman (gravida 1, para 0) was referred from a local clinic for a ruptured left tubal pregnancy at amenorrhea 5+0 weeks with elevated serum beta human chorionic gonadotropin (16,618 mIU/mL). A pregnancy on the left posterior wall of the uterine serosa was diagnosed during the operation and successfully treated with laparoscopic surgery as a conservative management strategy to enable fertility preservation. With the advantages of ultrasonography and laparoscopy, an early diagnosis of a primary abdominal pregnancy located on the left posterior wall of the uterine serosa was made, prior to the occurrence of severe intra-abdominal massive hemorrhage, which was then treated laparoscopically as a conservative management strategy enabling the preservation of fertility.

Unusual Contiguous Soft Tissue Spread of Advanced Malignant Mesothelioma Detected by FDG PET/CT / 대한핵의학회잡지

Malignant pleural mesothelioma (MPM) is a tumor of mesodermal origin that arises from the serosa of the pleura, peritoneum, pericardium or tunica vaginalis. MPM is well known to have a poor prognosis with a median survival time of 12 months. Accurate diagnosis, staging and restaging of MPM are crucial with [18F] flurodeoxy-D-glucose positron emission tomography (FDG PET/CT) playing an increasingly important role. Here we report a case of MPM with unusual contiguous soft tissue spread of the tumor along the dermal and fascial planes characterized by PET/CT. Given that the loco-regional tumor in the thorax was under control on PET/CT, the death of the patient was most likely associated with physiologic or metabolic causes associated with an extra-thoracic tumor.

Prognostic significance of intraoperative macroscopic serosal invasion finding when it shows a discrepancy in pathologic result gastric cancer

PURPOSE: Depth of wall invasion is an important prognostic factor in patients with gastric cancer, whereas the prognostic significance of intraoperative macroscopic serosal invasion (mSE) findings remain unclear when they show a discrepancy in pathologic findings. This study, therefore, assessed the prognostic significance of mSE. METHODS: Data from cohort of 2,835 patients with resectable gastric cancer who underwent surgery between 1990 and 2010 were retrospectively reviewed. RESULTS: The overall accuracy of mSE and pathologic results was 83.4%. The accuracy of mSE was 75.5% in pT2. On the other hand, the accuracy of pT3 dropped to 24.5%. According to mSE findings (+/-), the 5-year disease-specific survival (DSS) rate differed significantly in patients with pT2 (+; 74.2% vs. -; 92.0%), pT3 (+; 76.7% vs. -; 91.8%) and pT4a (+; 51.3% vs. -; 72.8%) (P < 0.001 each), but not in patients with T1 tumor. Multivariate analysis showed that mSE findings (hazard ratio [HR], 2.275; 95% confidence interval [CI], 1.148-4.509), tumor depth (HR, 6.894; 95% CI, 2.325-20.437), nodal status (HR, 5.206; 95% CI, 2.298-11.791), distant metastasis (HR, 2.881; 95% CI, 1.388-6.209), radical resection (HR, 2.002; 95% CI, 1.017-3.940), and lymphatic invasion (HR, 2.713; 95% CI, 1.424-5.167) were independent predictors of 5-year DSS rate. CONCLUSION: We observed considerable discrepancies between macroscopic and pathologic diagnosis of serosal invasion. However, macroscopic diagnosis of serosal invasion was independently prognostic of 5-year DSS. It suggests that because the pathologic results could not be perfect and the local inflammatory change with mSE(+) could affect survival, a combination of mSE(+/-) and pathologic depth may be predictive of prognosis in patients with gastric cancer.

Uterine rupture in pregnancies following myomectomy: A multicenter case series

OBJECTIVE: The purpose of this case series was to retrospectively examine records of cases with uterine rupture in pregnancies following myomectomy and to describe the clinical features and pregnancy outcomes. METHODS: This study was conducted as a multicenter case series. The patient databases at 7 tertiary hospitals were queried. Records of patients with a diagnosis of uterine rupture in the pregnancy following myomectomy between January 2012 and December 2014 were retrospectively collected. The uterine rupture cases enrolled in this study were defined as follows: through-and-through uterine rupture or tear of the uterine muscle and serosa, occurrence from 24+0 to 41+6 weeks' gestation, singleton pregnancy, and previous laparoscopic myomectomy (LSM) or laparotomic myomectomy (LTM) status. RESULTS: Fourteen pregnant women experienced uterine rupture during their pregnancy after LSM or LTM. Preterm delivery of less than 34 weeks' gestation occurred in 5 cases, while intrauterine fetal death occurred in 3, and 3 cases had fetal distress. Of the 14 uterine rupture cases, none occurred during labor. All mothers survived and had no sequelae, unlike the perinatal outcomes, although they were receiving blood transfusion or treatment for uterine artery embolization because of uterine atony or massive hemorrhage. CONCLUSION: In women of childbearing age who are scheduled to undergo LTM or LSM, the potential risk of uterine rupture on subsequent pregnancy should be explained before surgery. Pregnancy in women after myomectomy should be carefully observed, and they should be adequately counseled during this period.

Evaluation of intraluminal pressure in cystorrhaphies with and without intestinal serosal patch supplementation from canine cadavers

PURPOSE:To evaluate the maximal intraluminal pressure (MIP) supported by canine cadaveric urinary bladders that underwent cystotomy followed by cystorraphy, with and without serosal patching-supplementation.METHODS:Two groups (n=8 each) were formed, and in one (conventional) the cystotomy was closed with cushing pattern. In the other group (serosal), the same procedure was performed, and a piece of jejunum was used for the construction of the serosal patching over the cystorraphy. MIP was measured by means of an invasive blood pressure transducer with closed stopcock attached to a multiparameter monitor. At the end of each measurement, the bladder body circumference was assessed.RESULTS:Mean±SD MIP sustained for the conventional and serosal groups were 28.88±5.08 and 65.38±10.99 mmHg, respectively (p<0.0001). Bladder circumference did not change significantly between groups (p=0.35) and did not correlate with MIP assessed in conventional (p=0.27; r=0.4379) and serosal groups (p=0.37; r=-0.3637).CONCLUSION:Serosal patch-supplemented cystorraphies were able to sustain intraluminal pressures 55.8% higher, than nonsupplemented cystorraphies in specimens from canine cadavers.

Dispositivo intrauterino parcialmente migrado e incrustado en serosa de rectosigmoides tras 8 años de inserción / Partially migrated intrauterine device embedded in the rectosigmoid serosa after 8 years of insertion

Se presenta el caso clínico de un dispositivo intrauterino parcialmente migrado a cavidad pélvica e incrustado en serosa de rectosigmoides luego de 8 años de su inserción. El diagnóstico se realizó mediante ecografía transvaginal y retiro del dispositivo por laparoscopia. Se realizó rafia de serosa rectal y de útero. La paciente tuvo un postoperatorio sin complicaciones.

It is shown the clinical case of an intrauterine device partially migrated to the pelvic cavity and embedded in the serous rectosigmoid eight years after insertion. The diagnosis was made by transvaginal ultrasound and laparoscopy removal of the device by laparoscopy. Suture of rectum serous and uterus were performed. The patient had an uneventful postoperative course.

Staging and response evaluation of gastric cancer: requirements and resolutions by multidisciplinary treatment / 中华胃肠外科杂志

The popularization of the multidisciplinary treatment has brought more demands to the radiological evaluation of the gastric cancer, which includes staging and response evaluation. Limited by the resolution, the present imaging modalities can not demonstrate tiny structures of the serosa, and the employment of the hyperattenuating serosa sign may improve the diagnostic performance of T4a. The spectral CT and diffusion weighted MRI may provide new potential methods for the staging of gastric cancer. Attention should be paid to the unresectable signs caused by the dispersed infiltration of adjacent fat space to the organs. The comprehensive evaluation of peritoneal metastasis should base on the sites and early signs. Diffusion weighted MRI may provide new indicator for the response evaluation of gastric cancer to neoadjuvant chemotherapy.

Effect of a spray formulation on the reproductive parameters of a susceptible population of Rhipicephalus (Boophilus) microplus / Efeitos de uma formulação pulverização sobre os parâmetros reproductivos de uma população susceptível de Rhipicephalus (Boophilus) microplus

The number of studies emphasizing the possible damage that acaricidal spray formulations can cause on engorged female ticks' reproductive parameters is small. The present study evaluated the deleterious effects of a spray formulation (dichlorvos 60% + chlorpyrifos 20%) on the reproductive parameters of a susceptible population of Rhipicephalus (B.) microplus females, using the Stall Test. The ticks were allocated randomly to treatments according to the mean numbers of females detached from each cow on days -3, -2 and -1 and the cattle pen location. The numbers of engorged female ticks that naturally detached from the cattle were counted daily from day 1 to day 30. For each group, 20 detached engorged female ticks or the available number collected daily were evaluated regarding reproductive parameters. Associations of organophosphates demonstrated elevated acaricidal efficacy, as well as deleterious effects on the reproductive parameters of R. (B.) microplus females. The engorged female weight (days 1 to 7), weight of egg masses (days 5 to 10) and larval hatching percentage (days 5 to 19) were decreased (P ≤ 0.05). It is possible that a formulation can lead to deleterious effects on R. (B.) microplus females when the tick population analyzed shows elevated sensitivity towards a particular formulation. However, further studies need to be conducted.

É relativamente pequeno o número de estudos que enfatiza os danos que uma formulação acaricida spray pode desencadear sobre os parâmetros reprodutivos das teleóginas. O presente estudo teve como objetivo avaliar os efeitos deletérios de uma formulação spray comercial (dichlorvos 60% + Clorpirifós 20%), sobre os parâmetros reprodutivos de uma população susceptível de R. (B.) microplus, desprendidas de bovinos experimentalmente infestados, utilizandose o teste de estábulo. Os animais foram alocados aos grupos de tratamentos de acordo com a contagem média de fêmeas desprendidas dos bovinos nos dias -3, -2 e -1. O número de teleóginas desprendidas foi quantificado do dia 1 ao 30. Para cada grupo, diariamente 20 fêmeas, ou a quantidade disponível, foram selecionadas e submetidas à avaliação dos parâmetros reprodutivos. A associação de organofosforados demonstrou elevada eficácia acaricida e também apresentou efeitos deletérios sob os parâmetros reprodutivos de Rhipicephalus (B.) microplus, diminuindo (P≤0,05) o peso das teleóginas (dos dias 1 ao 7), o peso da massa de ovos (dos dias 5 ao 10) e a eclodibilidade das larvas (dos dias 5 ao 19). Talvez uma formulação pode apresentar efeitos deletérios sobre os parâmetros reprodutivos de fêmeas de R. (B.) microplus, quando existe um elevado grau de sensibilidade dessa cepa de carrapato a um determinado composto. De qualquer maneira, futuros estudos devem ser realizados.

A matched cohort study of laparoscopy-assisted and open total gastrectomy for advanced proximal gastric cancer without serosa invasion / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Little is known about the feasibility and safety of laparoscopy-assisted total gastrectomy (LATG) with extended lymphadenectomy in patients with advanced gastric cancer (AGC). This study compared the technical feasibility, safety, and oncologic efficacy of LATG with open total gastrectomy (OTG) for AGC without serosa invasion.</p><p><b>METHODS</b>From January 2009 to December 2011, 235 patients underwent LATG and 153 patients underwent OTG for AGC without serosa invasion. Age, gender, and depth of invasion (pT2 and pT3) were matched by propensity scoring, and 116 patients (58 LATG and 58 OTG) were selected for analysis. Their clinicopathologic characteristics, postoperative outcomes, and survival were compared.</p><p><b>RESULTS</b>There was no significant difference in clinicopathologic characteristics between the two propensity-matched groups. Median number of lymph nodes per patient was 29, and the mean number of retrieved lymph nodes was similar in the LATG and OTG groups (30.8±10.2 vs. 29.0±8.3). Peri-operative characteristics, operation time, number of transfused units per patient, and time to resumption of activities were similar in the two groups; while blood loss, times to first flatus and resumption of soft diet, and post-operative stay were significantly lower in the LATG group (P < 0.05, respectively). Rates of post-operative complications (12.1% vs. 15.5%) and postoperative mortality (0% vs. 1.7%), as well as cumulative survival rates, were similar.</p><p><b>CONCLUSIONS</b>LATG with D2 lymphadenectomy is a safe and feasible procedure for AGC patients without serosa invasion. Prospective, multicenter, randomized trials are needed to confirm the efficacy of LATG in this patient population.</p>

A Case of Primary Mature Teratoma of the Rectum

A mature teratoma is a tumor composed of normal derivatives of all three germ layers, and usually occurs in ovaries, testes, or mediastinum. Mature teratoma of the gastrointestinal tract occurs less frequently, and case reports of primary mature teratoma of the rectum have not been published much. Here, we report a 65-year-old woman patient presented with lower abdominal discomfort. Colonoscopy revealed a pedunculated polypoid tumor arising from the rectum with hairs on its surface, and endoscopic ultrasound revealed an exophytic pattern bulging from the serosa. The tumor was removed surgically and confirmed histologically as a benign, primary mature teratoma of the rectum.