Intra-Abdominal Abscess of Unusual Origin.

This article describes the case of a woman who unknowingly swallowed several fishbones, one of which perforated the intestinal wall and subsequently formed an intra-abdominal abscess due to the foreign body reaction.

Partial staple line reinforcement with synthetic buttressing material in laparoscopic sleeve gastrectomy: a propensity score-matched analysis.

PURPOSE: Staple line leakage (SLL) and staple line bleeding (SLB) are the most relevant postoperative complications of sleeve gastrectomy (SG). It is controversial whether and which method of staple line reinforcement (SLR) can best reduce these complications. The primary objective of this study was to investigate whether reinforcement of the most proximal part of the staple line with synthetic buttressing material, a strategy we termed partial SLR (p-SLR), reduces the 30-day incidence of SLL. METHODS: A retrospective search of medical records of all bariatric patients from 2010 to 2019 was performed. Patients who underwent SG with either p-SLR or non-SLR were included. Intraoperative and postoperative outcomes were analyzed before and after propensity score matching (PSM). RESULTS: Data from 431 patients were analyzed (364 in the p-SLR group and 67 in the non-SLR group). No difference in the 30-day incidence of SLL was observed between the two groups. The 30-day incidence of SLB (1.1% vs. 6.0% in the p-SLR and non-SLR groups, respectively) was significantly lower in the p-SLR group. These results were confirmed by PSM analysis. CONCLUSION: Partial staple line reinforcement with synthetic buttressing material does not reduce the 30-day incidence of SLL. Although our analysis showed a significant reduction in the 30-day incidence of SLB in the p-SLR group, this result should be interpreted with caution.

Effects of short or long biliopancreatic limb length after laparoscopic Roux-en-Y gastric bypass surgery for obesity: a propensity score-matched analysis.

PURPOSE: Although recent studies reported superior weight reduction in patients undergoing Roux-en-Y gastric bypass (RYGB) with long biliopancreatic limb (BPL), no recommendation regarding limb lengths exists. This study compares weight loss and resolution of obesity-related comorbidities in patients undergoing RYGB with either long or short BPL. METHODS: A retrospective data search from medical records was performed. A total of 308 patients underwent laparoscopic RYGB with a BPL length of either 100 cm or 50 cm. Data was analyzed before and after propensity score matching. RESULTS: No statistically significant difference in weight reduction between long and short BPL RYGB in terms of percentage of excess weight loss (%EWL) (86.4 ± 24.5 vs. 83.4 ± 21.4, p = 0.285) and percentage of total weight loss (%TWL) (32.4 ± 8.4 vs. 33.0 ± 8.3, p = 0.543) was found 24 months after surgery. Propensity score-matched analysis did not show any statistically significant difference between groups in both %EWL and %TWL. No significant difference between long and short BPL RYGB in the resolution of obesity-related comorbidities was noted 24 months after surgery. CONCLUSION: Weight loss and resolution of obesity-related comorbidities were not significantly different between long and short BPL RYGB 24 months after surgery.

Schwann Cell Expressed Nogo-B Modulates Axonal Branching of Adult Sensory Neurons Through the Nogo-B Receptor NgBR.

UNLABELLED: In contrast to the central nervous system (CNS) nerve fibers do regenerate in the peripheral nervous system (PNS) although in a clinically unsatisfying manner. A major problem is excessive sprouting of regenerating axons which results in aberrant reinnervation of target tissue and impaired functional recovery. In the CNS, the reticulon protein Nogo-A has been identified as a prominent oligodendrocyte expressed inhibitor of long-distance growth of regenerating axons. We show here that the related isoform Nogo-B is abundantly expressed in Schwann cells in the PNS. Other than Nogo-A in oligodendrocytes, Nogo-B does not localize to the myelin sheath but is detected in the ER and the plasma membrane of Schwann cells. Adult sensory neurons that are cultured on nogo-a/b deficient Schwann cells form significantly fewer axonal branches vs. those on wildtype Schwann cells, while their maximal axonal extension is unaffected. We demonstrate that this effect of Nogo-B on neuronal morphology is restricted to undifferentiated Schwann cells and is mediated by direct physical contact between these two cell types. Moreover, we show that blocking the Nogo-B specific receptor NgBR, which we find expressed on sensory neurons and to interact with Schwann cell expressed Nogo-B, produces the same branching phenotype as observed after deletion of Nogo-B. These data provide evidence for a novel function of the nogo gene that is implemented by the Nogo-B isoform. The remarkably specific effects of Nogo-B/NgBR on axonal branching, while leaving axonal extension unaffected, are of potential clinical relevance in the context of excessive axonal sprouting after peripheral nerve injury. MAIN POINTS: Nogo-B is prominently expressed in Schwann cells and localizes to the ER and plasma membrane. It distributes to the external cytoplasmic compartment of Schwann cells in vivo, but is absent from the myelin sheath.Genetic deletion of Nogo-B in Schwann cells reduces axonal branching, but not long-distance growth, of co-cultured adult sensory neurons.Schwann cell expressed Nogo-B interacts with neuronal NgBR. Blockade of NgBR mimics the loss-of-nogo branching phenotype.