2010.35; published online 31 March 2010″
“Objective: Laparoscopic repair of giant paraesophageal hernia is a complex operation requiring significant laparoscopic expertise. Our objective was to compare our current approach
and outcomes for laparoscopic repair of giant paraesophageal hernia with our previous experience.
Methods: A retrospective review of patients undergoing nonemergency laparoscopic repair of giant paraesophageal hernia, stratified by early versus current era (January 1997-June 2003 and July 2003-June 2008), was performed. We evaluated clinical outcomes, barium esophagogram, and quality of life.
Results: Laparoscopic repair of giant paraesophageal hernia was performed in 662 patients (median age 70 years, range 19-92 years) with a median percentage of herniated stomach of 70%(range 30%-100%). With time, use of Collis gastroplasty decreased (86% to PF-02341066 research buy 53%), as did crural mesh reinforcement (17% to 12%). Current era patients were 50% more likely JQ-EZ-05 in vitro to have a Charlson comorbidity index score greater than 3. Thirty-day mortality was 1.7%(11/662). Mortality and complication rates were stable with time, despite increasing comorbid disease in current era. Postoperative gastroesophageal reflux disease health-related
quality of life scores were available for 489 patients (30-month median follow-up), with good to excellent results in 90%(438/489). Radiographic recurrence (15.7%) was not associated with symptom recurrence. Reoperation occurred in 3.2% (21/662).
Conclusions: With time, we have obtained significant minimally invasive experience and refined our approach
to laparoscopic repair of giant paraesophageal hernia. Perioperative morbidity and mortality remain low, despite increased comorbid disease in the current era. selleck compound Laparoscopic repair provided excellent patient satisfaction and symptom improvement, even with small radiographic recurrences. Reoperation rates were comparable to the best open series. (J Thorac Cardiovasc Surg 2010; 139: 395-404)”
“STOP (stable tubule only polypeptide) null mice display neurochemical and behavioral abnormalities that resemble several well-recognized features of schizophrenia. Recent evidence suggests that the hematopoietic growth factor erythropoietin improves the cognitive performance of schizophrenics. The mechanism, however, by which erythropoietin is able to improve the cognition of schizophrenics is unclear. To address this question, we first determined whether acute administration of the erythropoietin analog known as darbepoetin alfa (D. alfa) improved performance deficits of STOP null mice in the novel objective recognition task (NORT). NORT performance of STOP null mice, but not wild-type littermates, was enhanced 3 h after a single injection of D. alfa (25 mu g/kg, i.p.).