Wound healing of laparoscopic esophageal myotomy with or without an added gastric patch.

BACKGROUND: The purpose of this research is to compare the wound healing of the laparoscopic esophagomyotomy with and without a gastric patch. METHODS: Twelve male pigs were distributed into two groups of six animals. Esophagomyotomy was performed in group A. A gastric patch was associated to the myotomy in group B. On the 21st postoperative day, lumen molding was accomplished to determine the index of stenosis (IS) at the area of myotomy (AM). Macroscopic and microscopic aspects of wound healing were also studied at AM. Three microscopic morphologic patterns were defined for morphometric evaluation: leukocytes (constituted by polymorphonuclear and mononuclear cells), new endothelial cells, and collagen fibers. RESULTS: There was a longer operative duration in group B (93.6 min) than in group A (45 min). At AM, IS was negative (lumen increased) and equivalent in both groups: -11.1% in group A and -12.7% in group B. Mesotelial epithelium covering RM was observed in group A. Inflammatory reaction was greater in group B in comparison with group A (leuCocytes: 22 cells versus 8.6; fibrosis: 25.5 fibers versus 15.6; granulation tissue: 18.7 vessels versus 9.7). CONCLUSION: Esophagomyotomy followed by gastric patch does not heal adequately and is worsened by the presence of foreign body granulomas around stitches. Myotomy without gastric patch is faster and causes lower inflammation. Myotomy alone or with gastric patch does not lead to esophageal stenosis at RM and does not lead to restoration of the esophageal musculature continuity.

Establishing and maintaining a low-cost zebrafish breeding and behavioral research facility.

The purpose of this paper is to describe how to establish and maintain a low-cost zebrafish facility that can be used for both teaching and research purposes. The cost of the facility ranges from about $250 to $1,000, depending on the size of the facility and the experiments that will be conducted. The facility plan presented here also has the advantage that it can be disassembled so that it need not function year-round. A detailed list of supplies and materials is provided, along with detailed instructions on how to set up and maintain the adult and breeding portions of the facility. Finally, there is discussion of some of the general uses of a zebrafish facility, including a variety of procedures that are currently being used in behavioral research with this species.

Acute severe hypercalcemia in a la Münchausen.

A 51 year old nurse had a long complicated medical history with repeated medical and surgical interventions. Her condition fits the clinical description of the Münchausen syndrome. She presented to the hospital with hyperabsorptive hypercalcemia of over 20 mg/100 ml. Many diagnostic studies and intriguing detective investigations were undertaken before the cause of the extreme hypercalcemia was determined. The patient had been secretly ingesting between 20 and 30 Os-Cal 500 tablets daily which she repeatedly denied and which eventually were found in a false compartment of her purse. This is thought to be the highest recorded serum calcium level observed following the clandestine ingestion of excessive amounts of oral calcium.