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Cottage cheese by the use of a creaming mixture prepared with Streptococcus citrovortis. J. Dairy Sci. 42: 1917. Olson, H. C., and O. D. Ball. 1957. Control of bacterial spoilage in Cottage cheese. J. Dairy Sci. 40: 1389. Abstr. ; Pagano, J. F., and H. Stander. 1955. Bioassay of nystatin mycostatin ; in body fluids in therapy of fungus diseases. Page 186 in An international symposium. T. H. Sternberg and V. D. Newcommer, eds. Little Brown Co., Boston, MA. Rhodes, M. D. 1953. A study of lipolytic and proteolytic spoilage of Cottage cheese. M. S. Thesis, Texas Tech. Coll., Lubbock, TX. Shahani, K. M., K. M. Nilson, and P. A. Downs. 1959. Effect of antifungal antibiotics upon the keeping quality of Cottage cheese. Proc. XV Int. Dairy Cong. 2: 926. Shahani, K. M., H. S. Goldberg. 1972. Inhibitory effect of pimaricin upon mold growth, metabolism, and toxin production. Page 22 in Proc. IUPAC Syrup. Control of mycotoxins, Aug. 21-22, Goteborg, Sweden. Yang, H. V., W. F. Steele, R. W. Stein, R. F. Cain, and R. O. Sinnhuber. 1958. Vitamin K 5 as food preservative. Food Technol. 12: 501.
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Three S. pneumoniae strains isolated from blood cultures of patients with pneumonia were used kindly provided by P. Geslin and F. Goldstein, France ; . The first strain 195; serotype 19 ; was known to be penicillin susceptible erythromycin resistant, the second strain 16089; serotype 9V ; erythromycin susceptible but penicillin resistant, and the last strain 11724; serotype 19 ; to be resistant to both penicillin and erythromycin. Purity was confirmed throughout the study by Gram's stain and colony morphology. Working stock cultures were kept frozen at 70C in a 15% glycerol supplemented brainheart infusion bioMrieux Laboratories, Marcy l'Etoile, France ; . In order to maintain virulence, stock cultures were changed monthly using isolates from rabbits with untreated S. pneumoniae pneumonia. For all strains, MIC and MBC were determined as described previously.17 For strain 11724, MIC and MBC were also determined before and after HMR 3647 preexposure. Effect of HMR 3647 pre-exposure was evaluated by pre-growth 8 h at 37C ; in brainheart medium at sub-inhibitory concentrations 0.25 MIC ; . The culture was then washed three times before MIC and MBC testing were performed.
4 rats with chronic hypoxia-induced PHT, total PDE activity is increased, primarily because of upregulated mRNA and protein expression and increased activity of PDE3A B a cGMP-inhibited cAMP-stimulated cAMP-hydrolyzing isoform ; and PDE5A a cGMP-specific isoform ; 9, 14 ; . PDE3 and PDE5 inhibitors both decrease pulmonary arterial pressure PAP ; and pulmonary vascular resistance PVR ; in animal models of PHT 7, 11 PDE3A, PDE3B and PDE5 are expressed in pulmonary arterial smooth muscle cells PASMC ; 14, 19 ; . Inhibition of PDE5 decreases proliferation of human PASMC and is more effective at raising cGMP than NO donors or a soluble guanylyl cyclase inhibitor 30 ; . Sildenafil, a selective PDE5 inhibitor, promotes pulmonary.
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Sumably, in these individuals, the hybrid genes occupy a more distal, 3' position in the gene array see gene expression, above ; . iv ; John Dalton's genotype: Historically, John Dalton is the most famous person known to be color blind. In his honor, the term daltonism is used in many languages, including English, French, Spanish, and Russian, to refer to color vision disorders. Believing his own colorblindness to be caused by his eye humors being blue-tinted, he directed that they be examined upon his death. However, a postmortem analysis conducted on 28 July 1844 failed to confirm his hypothesis Wilson, 1845; Henry, 1854 ; . Fortunately, sufficient eye tissue was preserved after the autopsy to permit, 150 years later, a molecular genetic analysis Hunt et al., 1995 ; . PCR amplification of opsin gene fragments from the tissue revealed that only a single L-cone opsin sequence was present, consistent with Dalton being a single-gene deuteranope see Figs. 1.9A and 1.15B ; . The genotype is contrary to previous interpretations, including that of Thomas Young 1807 ; , who thought Dalton a protanope. But it accords with a close reading of the historical record and with colorimetric analysis of the color confusions and failures of color constancy reported by Dalton himself Dalton, 1798; Hunt et al., 1995 ; . These findings represent, to date, the most impressive example of genotyping of a known historical figure, and they provide a satisfying historical continuity to the field of the molecular genetics of color blindness. Large-field trichromacy. Nagel 1905, 1907 ; was the first to observe that many red-green dichromats, himself included, are only completely dichromatic for small viewing fields restricted to the central fovea. With larger viewing fields, they become partially trichromatic and are able to make red-green color discriminations. Nagel's observations have been confirmed by many others relying on small- and largefield Rayleigh or neutral point matches Jaeger & Kroker, 1952; Smith & Pokorny, 1977; Nagy, 1980; Breton & Cowan, 1981 ; and color naming Scheibner & Boynton, 1968, Nagy & Boynton, 1979; Montag and nafcillin.
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Bifurcations, avoiding the bifurcation pads intimal cushions ; . The tissue blocks were dehydrated through increasing concentrations of ethanol and were embedded in paraffin. Five 5 fim sections were cut from each block and were stained with Verhoeff van Gieson stain. The area occupied by the intima and intimal lesion was measured mm2 ; using a Zeiss MOP III Image Analyzer. While the intimal area IA ; was determined from one section of the LCB and RCB, the values of all sections taken from the LC and the RC were averaged for use in analysis. The data were collected in a similar fashion from the coronary arteries and are presented elsewhere.32 Statistical Analysis Logarithmic transformation of plasma lipid concentrations and lesion areas was used to reduce skewness and equalize group variances. Preliminary analyses using one-way analysis of variance ANOVA, 1 x 3 Experimental Groups ; and analysis of covariance ANCOVA ; adjusted for baseline factors used in the matched randomization were used to examine the potential influence of OC administration on the plasma lipid and adiposity measures reported here. The ANOVA and the ANCOVA elicited the same results; thus, only the results of the ANOVA are presented here. OC administration had no effect on whole-body POND p 0.72 ; or body fat distribution as measured by the SS: TRI ratio p 0.65 ; . The independent effects of OC administration and regional adiposity on carotid artery atherosclerosis were examined by two-way ANOVA. A 2 x ANOVA Regional Adiposity x Experimental Group ; was used to examine the effects of OC administration and regional adiposity on IA. Simultaneous analysis of social status, regional adiposity, and experimental group three-way ANOVA ; was not statistically feasible due to small cell sizes. Thus, supplemental ANOVAs Statusx Experimental Group ; were used to examine the relationship between social status and carotid artery atherosclerosis. Pearson correlations were used to measure the degree of association between carotid atherosclerosis extent IA ; , whole-body POND, BP, and plasma lipid concentrations. Finally, multipleregression analyses were used to simultaneously assess the relative strength of the associations between significant risk variables and carotid artery atherosclerosis extent, with grouping variables added to account for the effects of OC treatment.28 Social status and regional adiposity were entered as continuous variables in these analyses. All bar graphs and the table depict the untransformed mean valuesSEM.
M. A. Mroginski1 , D. von Stetten1 , P. Hildebrandt1 and F. Mark2 1 TU-Berlin, Institute f. Chemistry, Sekr. PC 14, Strasse des 17. Juni 135, Berlin 2 Max-Planck-Institut f. Bioanorganischechemie, Stiftstr. 34-36, Mlheim an der Ruhr Phone: + 49 30 ; 31421584, Fax: + 49 30 ; 21122 Email: andrea.mroginski tu-berlin Phytochromes are a family of sensory photoreceptors in higher plants controlling a variety of photomorphogenic processes. The absorption of light induces a reaction cycle of the tetrapyrrolic phytochromobilin chromophore which allows the interconversion of the chromoprotein between two stable states, a red-absorbing and physiologically inactive Pr state and a far-red absorbing and physiologically active Pfr state. The conformational changes of the chromophoric site of Phytochrome phytochrome A from Avena Sativa ; during the photoconversion processes can be studied by resonance Raman spectroscopy [1]. However, since a three-dimensional structure of phytochrome has not yet been solved, interpretation of the vibrational spectra in terms of chromophore and protein structure changes is not unambiguos. In this work, we have employed a quantum chemical approach, based on Density Functional Theory DFT ; [2] [3], to carry out a comprehensive vibrational analysis of the measured preresonance-Raman spectra of the protein. The DFT force fields, obtained with the B3LYP functional and 6-31G * basis set, were corrected by a global set of scaling factors. The Raman spectra of various conformations and configurations of the single and double bonds of the methine bridges of a Phytochromobilin PB ; model compound were calculated. Comparison between the experimental pre-resonance Raman spectra of Phytochrome A, and the calculated Raman spectra of the model compound suggest a ZZZasa conformation of the PB chromophore of Phy A at the Pr state figure 1 ; . Furthermore, our results confirm a Z E isomerization of the C 15 ; C double bond at the Lumi-R state and a rotation of the C 5 ; -C single bond during the thermal relaxation of the chromophore inside the protein pocket towards the Pfr state. [1] [2] [3] Kneip, C. et al. Biochemistry 38, 15185-15192. 1999 ; . Mroginski, MA et al. J.Phys. Chem. B 104, 10885-10899. 2000 ; . Magdo, I. et al. J. Phys. Chem. A 103, 289-303. 1999 and naloxone.
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The present study is the first to examine mechanisms of RV O2 demand supply balance during systemic hypoxia. In this condition, RV O2 consumption increases due to elevated heart rate and RV systolic pressure and dP dtmax, resulting from increased sympathetic activation 14, 16, 18 ; . Hypoxia-induced pulmonary vasoconstriction also contributes to the rise in RV systolic pressure 6, 43 ; . In the face of this increased RV O2 consumption, arterial O2 content falls during hypoxia. To.
While studying historical documentaries, we can see that a few stereotypes still have a pronounced presence. For example, the cover of Charlemagne Bhrer-Thierry, 1996 ; represents the emperor with a beard whereas historians proved years ago that he wasn't bearded. Antoine Auger, in his Charlemagne et son temps Charlemagne and his times; Auger 2001, cov. ; prefers playing on the nuances of red and on graphics so that the reader doesn't see if Charlemagne has got a beard or not : the artist played on the pronounced stereotype and the true appearance of the character at the same time. Another kind of stereotype: inserting contemporary representations in a given era. In Les Gaulois The Gauls ; Lescarret 2001, 7 ; , we see on page 7 a family scene where people are drinking barley beer in front of their village. A young woman is hanging back on the left, waiting, without a doubt, for serving the other masculine characters. A dog is standing near its master. This scene borders on a caricature of a modern family who spend their holiday in a village-club whereas the text denounces on page 6 the stereotypes about the Gauls which flourished in the texts of that time and naltrexone.
24 Specific recommendation to review 2 weeks after starting therapy in order to assess adherence, as well as antiretroviral toxicity 16 02 05 - FEEDBACK Patients should be reviewed two weeks after starting antiretroviral therapy, in order to assess side effects and adherence. A full blood examination, urea and electrolytes and liver function tests should be requested.
PTFE ; arterial anastomoses. If after momentary release of the arterial clamp, adjunctive hemostatic measures were required, subjects were randomized to receive fibrin sealant or MC. For subjects who received fibrin sealant, the product was applied and allowed to cure for 1 minute prior to clamp release. In the MC group, clamp release was immediate, and light manual pressure with gauze sponges was applied. The primary endpoint was the absence of bleeding at the anastomosis at 4 minutes following randomization. Secondary endpoints included hemostasis at 7 and 10 minutes post-randomization, treatment failures, and the incidence of complications that were potentially related to bleeding. Between-group differences in the primary and secondary endpoints were analyzed using a logistic model; 2-sided 95% confidence intervals CIs ; were also constructed to evaluate between-group differences. Adverse events were recorded. Results Subjects N 147 ; were randomized to receive fibrin sealant n 75 ; or higher percentage of subjects who received fibrin sealant versus MC achieved hemostasis at 4 minutes Table ; . Similarly, a higher percentage of subjects in the fibrin sealant group achieved hemostasis at the 7- and 10-minute time points compared with subjects who received MC Table ; . A lower incidence of treatment failures was observed in the fibrin sealant group; the incidence of complications that were potentially related to bleeding was similar between the groups Table ; . The percentage of subjects in each group who experienced 1 adverse event was also similar fibrin sealant, 64.0%; MC, 70.8% ; . Table - Safety and Effectiveness Endpoints Endpoint Fibrin MC Odds sealant n 72 ; ratio n 75 ; Hemostasis at: 4 minutes 64 28 9.1 ; 38.9% ; 7 minutes 68 43 6.5 ; 59.7% ; 10 minutes 72 50 10.9 ; 69.4% ; Treatment 6 23 0.18 failure 8.0% ; 31.9% ; Complications 12 15 potentially 16.0% ; 20.8% ; related to bleeding 95% Ci P value processed by a cell salvage device for up to 6 hours and filter the red blood cells, retaining microaggregates greater than 40. Materials and Methods The 40 RBC Filter Bag is a filter-in-a-bag design comprised of a flexible PVC outer bag with an integral flexible 40 mesh filter. The entry port connects the cell salvage device output directly to one side of the mesh filter while the exit port to the re-infusion line connects only to the compartment on the other side. The bag is made in two sizes, 400mL and 1000mL. A laboratory study was conducted to assess the particle removal efficiency of the Filter Bag and its performance against published filtration standards. Additionally, three institutions evaluated the Filter bags in their surgical practice; two used the 1000mL bag with the Cell Saver 5 n 20 cardiac patients ; and the other used the 400 mL bag with the OrthoPAT device 40 hip or knee replacement patients ; . Blood shed from either a surgical site or wound drain was salvaged, washed, and passed through the filter bags. The surgical staff evaluations of filter bag performance and satisfaction were collected via survey. Results The particle removal efficiency study confirmed that the 40 Filter Bag can be used with the PAT or the Cell Saver devices to provide RBC products up to 6 hours after cell salvage that exhibit with 95% confidence ; that 95% of the units will have 93% 400 mL bag ; and 91% 1000 mL bag ; removal of microaggregates that are 40 in size. The Filter Bag functioned as designed and met the ANSI AAMI BF7-1989 filtration standard of removing 80% particulates greater than 40 microns. The product evaluation surveys indicated a high level of customer satisfaction with the filter bags' performance, packaging, labeling, and ease of use. The institutions currently utilizing an extra 40 filter indicated they would move to the 40 Filter Bag approach. Conclusion The 400- and 1000-mL 40 Filter Bags are easy to use and meet performance standards. These devices eliminate the need for additional 40 filtration of autotransfusion blood prior to re-infusion. * K. Elsner is an employee of Haemonetics Corporation ProCess iMProveMenT: oTher ; aPPlying besT Care in blood ManageMenT #172 A Well Qualified Blood Management Coordinator Can Overcome Barriers and Facilitate Application of New Scientific Knowledge to Clinical Practice Karen L. Scalici, RN, St John Detroit Riverview Hospital, Detroit, Michigan The Institute of Medicine's 2001 report, Crossing the Quality Chasm, informs that scientific knowledge about best care is not applied systematically or in a timely manner to clinical practice. Extreme variability in practice in clinical areas in which there is strong scientific evidence and a high degree of expert consensus about best practices indicates that current dissemination efforts fail to reach practitioners who deliver patient care. One reason may be that medicine is very specialized. Every physician is struggling to keep up with new medical knowledge and technology in their own field. There is little time for conferences, dinner meetings, articles or discussions with colleagues about best practice in blood management. Even when physicians are informed, applying it to clinical practice is difficult without a blood management champion. This poster demonstrates the role a blood management coordinator can play in overcoming barriers to applying scientific knowledge about best care in blood management to clinical practice, with or without a dedicated physician leader. The and namenda.
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Study visits and assessments were scheduled every 2 weeks during the 48-week treatment period Figure 1 ; . All laboratory assessments were performed by a central laboratory, EXACTA Clinical Trials Services, Verona, Italy. Safety assessments included monitoring and recording adverse events AEs ; at each study visit. The severity of each AE was graded as mild, moderate or severe. Serious adverse events SAEs ; were defined as a medically significant event that was either fatal or life-threatening, required surgical intervention, prolonged hospitalization or resulted in persistent disability. All AEs and SAEs were assessed by the investigator for a possible relationship to the study drug. Laboratory abnormalities were only recorded as an AE they induced clinical signs or symptoms considered clinically significant or if they required therapy. Other safety evaluations included regular evaluation of renal function by assessing serum creatinine and total urinary protein. An increase in serum creatinine of 33% from baseline at two consecutive measurements ; was considered a notable finding. Urinary protein to creatinine ratio was also computed, and compared against the notable and extended ranges urinary protein creatinine ratio: 0.2; to 0.4; to 0.6; and 0.6 ; . The creatinine clearance was calculated using the Schwartz formula.14 In addition, liver function tests, liver ultrasound, electrocardiograms ECG ; , audiometry, ophthalmology, and sexual and physical development were assessed at regular intervals during the study. Sexual and mycostatin.
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89. Toro JR, Liewehr DJ, Pabby N, et al. Gammadelta T-cell phenotype is associated with significantly decreased survival in cutaneous T-cell lymphoma. Blood. 2003; 101: 3407-3412. Belhadj K, Reyes F, Farcet JP, et al. Hepatosplenic T-cell lymphoma is a rare clinicopathologic entity with poor outcome: report on a series of 21 patients. Blood. 2003; 102: 4261-4269. Przybylski GK, Wu H, Macon WR, et al. Hepatosplenic and subcutaneous panniculitis-like gamma delta T cell lymphomas are derived from different Vdelta subsets of gamma delta T lymphocytes. J Mol Diagn. 2000; 2: 11-19. Farcet JP, Gaulard P, Marolleau JP, et al. Hepatosplenic T-cell lymphoma: sinusal sinusoidal localization of malignant cells expressing the T-cell receptor gamma delta. Blood. 1990; 75: 22132219. Suarez F, Wlodarska I, Rigal-Huguet F, et al. Hepatosplenic T-cell lymphoma: an unusual case with clinical, histologic, and cytogenetic features of hepatosplenic T-cell lymphoma. J Surg Pathol. 2000; 24: 1027-1032. Iannitto E, Barbera V, Quintini G, Cirrincione S, Leone M. Hepatosplenic T-cell lymphoma: complete response induced by treatment with pentostatin. Br J Haematol. 2002; 117: 995-996. Chanan-Khan A, Islam T, Alam A, et al. Long-term survival with allogeneic stem cell transplant and donor lymphocyte infusion following salvage therapy with anti-CD52 monoclonal antibody Campath ; in a patient with alpha beta hepatosplenic T-cell non-Hodgkin's lymphoma. Leuk Lymphoma. 2004; 45: 1673-1675. Jaffe ES, Chan JK, Su IJ, et al. Report of the Workshop on Nasal and Related Extranodal Angiocentric T Natural Killer Cell Lymphomas: definitions, differential diagnosis, and epidemiology. J Surg Pathol. 1996; 20: 103-111. Kim GE, Lee SW, Chang SK, et al. Combined chemotherapy and radiation versus radiation alone in the management of localized angiocentric lymphoma of the head and neck. Radiother Oncol. 2001; 61: 261-269. Cheung MM, Chan JK, Lau WH, et al. Primary non-Hodgkin's lymphoma of the nose and nasopharynx: clinical features, tumor immunophenotype, and treatment outcome in 113 patients. J Clin Oncol. 1998; 16: 70-77. Quintanilla-Martinez L, Franklin JL, Guerrero I, et al. Histological and immunophenotypic profile of nasal NK T cell lymphomas from Peru: high prevalence of p53 overexpression. Hum Pathol. 1999; 30: 849-855. Ko YH, Ree HJ, Kim WS, Choi WH, Moon WS, Kim SW. Clinicopathologic and genotypic study of extranodal nasal-type natural killer T-cell lymphoma and natural killer precursor lymphoma among Koreans. Cancer. 2000; 89: 2106-2116. Chiang AK, Chan AC, Srivastava G, Ho FC. Nasal T natural killer NK ; -cell lymphomas are derived from Epstein-Barr virus-infected cytotoxic lymphocytes of both NK- and T-cell lineage. Int J Cancer. 1997; 73: 332-338. Siu LL, Wong KF, Chan JK, Kwong YL. Comparative genomic hybridization analysis of natural.
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DCIS Update Ductal carcinoma in situ DCIS ; is considered a pre-cancer because it is not able to spread to other parts of the body--the hallmark of cancer. However, if left untreated, about 30 percent of women with DCIS would develop invasive breast cancer. Because we don't yet know how to tell which DCIS will become invasive and which won't, we treat all women who are found to have DCIS. Micrometastases in Women with DCIS Even though DCIS is by definition noninvasive, there are times when solitary cancer cells or micrometastases small clusters of 1020 cells ; are found in the sentinel nodes of women with DCIS. To determine the significance of these findings, researchers from the Netherlands conducted a retrospective study of women with DCIS, or with invasive ductal or lobular carcinoma that was 5mm or less in size, who had an axillary lymph node dissection as part of their surgery. The study found it was not uncommon to detect lymph node metastases in women who have DCIS or very small invasive low-risk tumors. These cells were found in 11 percent 7 66 ; of the women with DCIS, 27 percent 3 11 ; of the women with DCIS and microinvasion, and 12 percent 2 17 ; of the women with invasive ductal or lobular carcinoma. However--and importantly--these solitary cells or micrometastases did not have any impact on survival. After 8.5 years of follow-up, all of the women remained disease-free, without having chemotherapy. Based on these findings the researchers concluded that it is not necessary to perform a full axillary node dissection when micrometastases are found in the sentinel node in women with DCIS or in women with T1a tumors who have no other negative prognostic factors. Susan says: This study confirms what many of us have thought for some time: The presence of micrometastases doesn't actually signify that the cancer has spread. In fact, the cells found in micrometastases are probably spread by the surgery and do not appear to have the potential to become malignant. These findings underscore that the presence of micrometastases in women with DCIS or small tumors does not signify that the cancer has spread to the lymph nodes or that an axillary lymph node dissection, a procedure that can put a woman at higher risk for developing lymphedema painful swelling of the arm ; , is necessary. The bottom line: Women with DCIS or small tumors who have micrometastases can be treated as nodenegative. This means that as long as no other negative prognostic factors are present, they do not need to be treated with chemotherapy. Wide Excision Alone for DCIS Because DCIS is, by definition, a pre-cancer, surgeons have hypothesized that there may be some instances, such as if the DCIS is small and Grade 1 or 2, that radiation might not be necessary if the tumor is removed with wide margins. DCIS is graded based on how the breast cells look. In low-grade DCIS, the cells look more like regular cells than do the cells in high-grade DCIS. Both high-grade DCIS and low-grade DCIS have a 30 percent chance of developing into an invasive cancer if left untreated. The difference is that high-grade DCIS does it faster and becomes a more aggressive invasive cancer while the low-grade DCIS does it slower and becomes a less aggressive invasive cancer and mysoline.
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D31 LONG-TERM OUTCOME OF LAPAROSCOPIC FUNDOPLICATION IN 174 CHILDREN WITH GASTROESOPHAGEAL REFLUX DISEASE GERD ; . I. Hoffman, T. Lerut, J. Mathei, J. Tack. KULeuven. Gastro-esophageal reflux GER ; is a common and mostly self-limiting problem in infants and young children. In a subgroup of children, persistent GERD may require acid suppressive and or prokinetic therapy, and in those who remain refractory, surgical intervention may be necessary. Although the Nissen fundoplication is the most widespread surgical procedure for children with pathological gastroesophageal reflux disease, data on the long-term outcome are scarce. Our aim was to assess the long-term outcome of children referred for antireflux surgery in our hospital. Methods : All children who underwent antireflux surgery between 01 1995 and 11 2005 were prospectively followed up at 1 year after surgery and in case of occurrence of gastrointestinal symptoms including dysphagia, diarrhoea or recurrent GERD. Results : 174 children 108 boys, mean age of 7.2 5.6 years ; , 72 of which had psychomotor retardation PMR ; , underwent a Nissen fundoplication, with a mean follow up time of 52 3 months. The fundoplication was completed laparoscopically in 96%, and short term complications occurred in 8 4.6% ; patients 1 haematoma, 4 herniations of the fundoplication at barium swallow 24 hours post-surgery, and 3 local surgical complications ; , requiring short-term reintervention in 7 patients 4% ; . At re-evaluation 13.2 10.7 months after surgery, 112 children 64.4% ; were asymptomatic. In the 62 children 35.6% ; with persisting or new symptoms, additional investigations showed anatomical deformities in 4.6% herniation of the wrap in 8 ; and dysphagia without anatomical deformity in 15 children 8.6% ; . Eleven patients 7.7% ; reported symptoms suggestive of dumping with feeding-induced pallor 9 ; , abdominal pain 8 ; , sweating 7 ; and diarrhea 5 ; . Recurrence of GERD-like symptoms was reported for 30 children 17.2% ; , but only 12 children had recurrent esophageal erosions. Repeat pH monitoring was performed in 69 children including those with recurrent symptoms or esophagitis ; , of which 7 10% ; were pathological. The cause of persisting symptoms remained unclear in 14 children 8% medical GERD therapy was prescribed to only 4.6% of children. During follow-up, surgical reintervention was done in 2 children 1% ; for GERD recurrence and in 5 children 2.8% ; for dysphagia. Conclusion : Anti-reflux surgery in children with refractory GERD successfully controls reflux in close to 90%, but is not devoid of complications. These include both short-term surgical complications and long-term medical complications like dysphagia, recurrent GERD or dumping syndrome and nardil.
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