โ Scribed by Koch, Wayne M.
No coin nor oath required. For personal study only.
A lively discussion followed the presentation on myomucosal tube or shunt by Dr. Strome. Questions as to the position of the base for the flap and other technical details were discussed, including the possible valve mechanism of the muscle band in the esophageal wall through which the myomucosal tube is directed. In the opinion of Dr. Strome, some of these muscle fibers retain contractile activity. As to the fate of this tube, several observers indicated that shortening would take place over time and that the shunt could be the equivalent of a TE puncture fistula. This would explain why 50% of patients discussed by Dr. Strome had required a duckbill prosthesis for proper functioning. Additional hypothetical benefits of the procedure were an increased ability to retain a prosthesis if necessary and a tendency of the mucosal shunt to remain open if the indwelling prosthesis should become dis-From the
๐ SIMILAR VOLUMES
Cantrell that a patient needs to experience the options for alaryngeal speech postoperatively before choosing among available alternatives. The majority of the audience seemed to be opposed to primary tracheoesophageal puncture (TEP). Nevertheless, Drs. Perry, Blom, and Singer believe that primary
This concluding commentary highlights common themes that emerged across the chapters in this volume. We identify strengths and limitations of the core competencies framework and discuss the importance of context, culture, and development for understanding the role of the core competencies in prevent
Knowledge of the causes and mechanism of development of gouty arthritis has been greatly expanded within the past 15 years (12). Nevertheless many gaps still exist. T h e molecular basis of the ability of the crystal of monosodium urate (3,4), but not that of cystine (5,6), to produce a disruption o