RESUMO
BACKGROUND: We compared the incidence of early hernia recurrence in nonrandomized but consecutive patients undergoing laparoscopic repair of paraesophageal hernia (LRPH) without and with excision of the hernia sac. METHODS: LRPH was completed in 55 of 58 patients. In the first 25 patients, the sac was not excised. Total sac excision was performed in the subsequent 30 patients. All patients had crural repair with or without fundoplication, or gastropexy. RESULTS: Mean age of patients was 68 years (range, 34-95). There were three conversions; one patient died postoperatively. Mean operative time was 225 min in the first group and 190 min in the sac excision group. Median length of stay was 2 days (range, 1-15) for both groups. CONCLUSIONS: A precise method of total sac excision simplified dissection. It also ensured complete reduction of the hernia and availability of adequate esophageal length. Operative time was not increased, and no subsequent early recurrences were observed (p < 0.05).
Assuntos
Hérnia Hiatal/cirurgia , Laparoscopia/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Diafragma/cirurgia , Feminino , Seguimentos , Humanos , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Recidiva , Resultado do TratamentoRESUMO
We have studied long-term (to 60 days) effects of 4 degrees C storage in culture media on the histologic, mechanical, and chemical properties of the cartilage from osteochondral shell allografts from the dog. The structural integrity of the cartilage matrix was intact up to 60 days of storage, for the mechanical properties represented by the aggregate modulus and apparent permeability remained normal. These data are supported by normal safranin-O staining as well as normal glycosaminoglycan content and total collagen concentration. However, chondrocyte viability, as assessed by 35SO4 uptake and hematoxylin and eosin preparations, decreased dramatically with time. We believe that the longer storage to 60 days is not indicated, unless conditions can be modified to maintain cell viability.
Assuntos
Cartilagem Articular/citologia , Preservação Biológica , Animais , Cartilagem Articular/química , Cartilagem Articular/transplante , Sobrevivência Celular , Temperatura Baixa , Colágeno/análise , Cães , Glicosaminoglicanos/análise , Fenazinas , Coloração e Rotulagem , Transplante HomólogoRESUMO
Differentiation of Trypanosoma brucei in the mammal limits the degree of parasitemia and prepares the trypanosome for passage back into the tsetse fly. In an attempt to define the signals that control differentiation, we found that theophylline, in contrast to indomethacin, blocked differentiation, prolonged parasitemia, elevated prostaglandin and cyclic AMP concentrations of rat plasma, and depressed intratrypanosomal cyclic AMP. Relatively nontoxic drugs that alter differentiation are powerful tools for elucidating the events that control this important process.