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Sample records for anti-obesity gastric bypass

  1. Euglycemia and normolipidemia after anti-obesity gastric bypass Euglucemia y normolipidemia después de derivación gástrica anti-obesidad

    Directory of Open Access Journals (Sweden)

    A. G. Ribeiro

    2009-02-01

    Full Text Available Weight loss and resolution of comorbidities is well established after modern bariatric procedures, however chronology of glyco-lipidic biochemical response is still debated. Objective: Aiming to analyze this variable as well as its correlation with food amount and composition, a prospective study was designed. Methodology: Eighty consecutive patients undergoing Roux-en-Y gastric bypass were investigated every three months until one year after surgery. Females only were accepted and variables included general and nutritional course as well as glucose and lipid measurements. Energy intake was documented including percentage of macronutrients in the diet. Results: Surgery was successful with about 71% excess body weight loss at the end of the first year. Mean energy intake on the 4 postoperative quarters was respectively 519.6 ± 306.6, 836.0 ± 407.9, 702.1 ± 313.1 and 868.8 ± 342.8 kcal/day (mean ± SD. Fat intake was initially low but reached 34.1 ± 7.9% of total calories at final measurement. Blood glucose and lipid fractions tended to be borderline or abnormal preoperatively, and favorably changed by 12 months. Consumption of glucose-and lipid-lowering medication significantly diminished, but each of these was still necessary in 6.3% of the group. Correlation between body mass index and also calorie intake versus glucose and lipid measurements was highly significant (P = 0.000. Conclusions: 1 Energy intake after operation was very low; 2 Weight loss proceeded rapidly and correlated with meal pattern; 3 Improvement of glucose and lipid tests was adequate but took several quarters to normalize; 4 Decreased requirements for glucose- and lipid-lowering medication was significant but not absolute; 4 Fat percentage of total calories exceeded 30% at the end of the observation period, despite recommendations to the contrary.Pérdida de peso y resolución de las comorbidades estan bien establecidas luego de los modernos procedimientos bari

  2. Gastric emptying after a new, more physiological anti-obesity operation: the Magenstrasse and Mill procedure

    International Nuclear Information System (INIS)

    The Magenstrasse and Mill (M and M) procedure for obesity is designed to preserve normal gastric emptying mechanisms. The hypothesis investigated in this study was that gastric emptying would be normal after the M and M gastroplasty. Gastric emptying studies were performed using both liquid and solid test meals, in ten morbidly obese patients (MO group) and in 13 patients after the M and M procedure (MM group). Seven people of normal weight served as controls and were matched for age, sex and height to the M and M and MO groups. Three years after the M and M procedure, mean (SD) weight loss was 42 (19) kg, with a mean loss of excess weight of 58% (20%). Gastric emptying half-times (t1/2) are expressed in minutes, as median values (25th and 75th percentiles). The t1/2 for solids was 97 (85-110) min in the control group, 140 (86-220) min in the MO group and 79 (46-150) min in the MM group. Median gastric emptying for solids was 0.7% (0.6%-0.8%) per minute in the control group, 0.5% (0.3%-0.8%) in the MO group and 0.9% (0.4%-1.4%) in the M and M group. There were no statistically significant differences in the emptying times of the three groups. It is concluded that the M and M procedure achieves acceptable weight loss, while preserving gastric emptying mechanisms and thus minimising possible side-effects such as vomiting, dumping and diarrhoea, which are common complications of gastric bypass procedures. (orig.)

  3. Gastric emptying after a new, more physiological anti-obesity operation: the Magenstrasse and Mill procedure

    Energy Technology Data Exchange (ETDEWEB)

    Carmichael, A.R.; Johnston, D.; Barker, M.C.J.; Bury, R.F.; Boyce, J.; Sue-Ling, H. [Leeds General Infirmary (United Kingdom)

    2001-09-01

    The Magenstrasse and Mill (M and M) procedure for obesity is designed to preserve normal gastric emptying mechanisms. The hypothesis investigated in this study was that gastric emptying would be normal after the M and M gastroplasty. Gastric emptying studies were performed using both liquid and solid test meals, in ten morbidly obese patients (MO group) and in 13 patients after the M and M procedure (MM group). Seven people of normal weight served as controls and were matched for age, sex and height to the M and M and MO groups. Three years after the M and M procedure, mean (SD) weight loss was 42 (19) kg, with a mean loss of excess weight of 58% (20%). Gastric emptying half-times (t{sub 1/2}) are expressed in minutes, as median values (25th and 75th percentiles). The t{sub 1/2} for solids was 97 (85-110) min in the control group, 140 (86-220) min in the MO group and 79 (46-150) min in the MM group. Median gastric emptying for solids was 0.7% (0.6%-0.8%) per minute in the control group, 0.5% (0.3%-0.8%) in the MO group and 0.9% (0.4%-1.4%) in the M and M group. There were no statistically significant differences in the emptying times of the three groups. It is concluded that the M and M procedure achieves acceptable weight loss, while preserving gastric emptying mechanisms and thus minimising possible side-effects such as vomiting, dumping and diarrhoea, which are common complications of gastric bypass procedures. (orig.)

  4. Your diet after gastric bypass surgery

    Science.gov (United States)

    ... low-fat or nonfat hard cheeses, cottage cheese, milk, and yogurt. After gastric bypass surgery, your body will not absorb some important vitamins and minerals. You will need to take these vitamins and ...

  5. Analgesic Treatment in Laparoscopic Gastric Bypass Surgery

    DEFF Research Database (Denmark)

    Andersen, Lars P H; Werner, Mads U; Rosenberg, Jacob;

    2014-01-01

    This review aimed to present an overview of the randomized controlled trials investigating analgesic regimens used in laparoscopic Roux-en-Y gastric bypass (LRYGB) surgery. Literature search was performed in PubMed and EMBASE databases in August 2013 in accordance to PRISMA guidelines. The...... literature search identified nine studies eligible for inclusion. The administration of nonsteroidal anti-inflammatory drugs, local anesthetics (intraperitoneally or subfascially/subcutaneously), transversus abdominis plane block, dexmedetomidine, and ketamine may improve analgesia compared to placebo...

  6. Atypical complications of gastric bypass surgery

    International Nuclear Information System (INIS)

    Although gastric bypass surgery continues to grow in popularity for weight loss and weight maintenance in the morbidly obese, there has been little attention given to the imaging of complications associated with these surgeries. The purpose of our study is to demonstrate the variety of gastric bypass surgery complications that can be identified radiographically, with attention to the more unusual complications. This study was performed with institutional Internal Review Board approval. We performed a 5-year retrospective review of all patients who had undergone gastric bypass surgery, had complications of the surgery, and had studies performed in our department to image these complications. These studies consisted of contrast fluoroscopy and CT. We identified the more common complications of anastomotic stenoses and anastomotic leaks. We also identified six unusual complications as follow: (1) internal herniation through the small bowel mesentery, (2) internal herniation through the transverse mesocolon, (3) external herniation through the abdominal wall incision, (4) enterocutaneous fistulas, (5) antiperistaltic construction of the Roux-en-Y, and (6) incorrect anstomoses of the Roux limbs resulting in a Roux-en-O configuration. Our findings show that a thorough understanding of expected postoperative bowel configuration is essential in the evaluation of these patients. In addition, fluoroscopic evaluation should assess not only anatomy, but also motility

  7. Obstetrical and neonatal outcomes in women following gastric bypass

    DEFF Research Database (Denmark)

    Berlac, Janne Foss; Skovlund, Charlotte Wessel; Lidegaard, Ojvind

    2014-01-01

    OBJECTIVE: To assess obstetrical and neonatal outcomes in women following gastric bypass, compared with adipose women without surgery and with a normal weight control population. DESIGN: Historical controlled cohort study. SETTING: Denmark. POPULATION: All women undergoing gastric bypass during the...... period 1996-2011, and subsequently giving birth. METHODS AND MAIN OUTCOME MEASURES: Obstetrical and neonatal outcomes in women without gastric bypass matched on age, parity, plurality, year, and body mass index, and normal weight women. RESULTS: In 415 women giving birth after gastric bypass we found...

  8. Hypoglycaemia after gastric bypass: mechanisms and treatment.

    Science.gov (United States)

    Ritz, P; Vaurs, C; Barigou, M; Hanaire, H

    2016-03-01

    Hypoglycaemia after gastric bypass can be severe, but is uncommon, and is sometimes only revealed through monitoring glucose concentrations. The published literature is limited by the heterogeneity of the criteria used for diagnosis, arguing in favour of the Whipple triad with a glycaemia threshold of 55 mg/dl as the diagnostic reference. Women who lost most of their excess weight after gastric bypass, long after the surgery was performed, and who did not have diabetes before surgery are at the greatest risk. In this context, hypoglycaemia results from hyperinsulinism, which is either generated by pancreas anomalies (nesidioblastosis) and/or caused by an overstimulation of β cells by incretins, mainly glucagon-like peptide-1 (GLP-1). Glucose absorption is both accelerated and increased because of the direct communication between the gastric pouch and the jejunum. This is a post-surgical exaggeration of a natural adaptation that is seen in patients who have not undergone surgery in whom glucose is infused directly into the jejunum. There is not always a correspondence between symptoms and biological traits; however, hyperinsulinism is constant if hypoglycaemia is severe and there are neuroglucopenic symptoms. The treatment relies firstly on changes in eating habits, splitting food intake into five to six daily meals, slowing gastric emptying, reducing the glycaemic load and glycaemic index of foods, using fructose and avoiding stress at meals. Pharmacological treatment with acarbose is efficient, but other drugs still need to be validated in a greater number of subjects (insulin, glucagon, calcium channel blockers, somatostatin analogues and GLP-1 analogues). Lastly, if the surgical option has to be used, the benefits (efficient symptom relief) and the risks (weight regain, diabetes) should be weighed carefully. PMID:26508374

  9. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

    Medline Plus

    Full Text Available ... to check their blood sugar several times a day. Other problems that patients with morbid obesity have ... a lap band and he’s discharged the next day. With the gastric bypass, the patient comes in ...

  10. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

    Medline Plus

    Full Text Available ... the gastric bypass Roux-en-Y is a superior procedure than the lap band. That given, we ... of the robot has been shown to be superior to the laparoscopic cases, that this will also ...

  11. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

    Medline Plus

    Full Text Available ... Anthony Gonzalez, and welcome to South Miami Hospital. We’re here for a live webcast, a fully robotic gastric bypass, as I mentioned, we’re in the operating room at South Miami ...

  12. Severe hypoglycaemia post-gastric bypass requiring partial pancreatectomy

    DEFF Research Database (Denmark)

    Patti, M E; McMahon, G; Mun, E C;

    2005-01-01

    AIMS/HYPOTHESIS: Postprandial hypoglycaemia following gastric bypass for obesity is considered a late manifestation of the dumping syndrome and can usually be managed with dietary modification. We investigated three patients with severe postprandial hypoglycaemia and hyperinsulinaemia unresponsive...

  13. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

    Medline Plus

    Full Text Available ... you a detailed account of how the operation works. During that time, I’d like to answer ... you’ll understand it. Basically, the gastric bypass works on two different principals for weight loss, one ...

  14. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

    Medline Plus

    Full Text Available ... The feet are in this direction. And the robot is brought and docked over the patient’s body ... this location where I will be using the robot to perform this fully robotic gastric bypass. So ...

  15. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

    Medline Plus

    Full Text Available ... Health South Florida Miami, FL May 20, 2010 I am Dr. Anthony Gonzalez, and welcome to South ... live webcast, a fully robotic gastric bypass, as I mentioned, we’re in the operating room at ...

  16. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

    Medline Plus

    Full Text Available ... Loss Surgery: The Fully Robotic Gastric Bypass Baptist Health South Florida Miami, FL May 20, 2010 I ... study in 1991 at the National Institute of Health in Washington, D.C. And what they looked ...

  17. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

    Medline Plus

    Full Text Available ... later, there was laparoscopic gastric bypass surgery. The learning curve, which is the time that it takes for the surgeon to learn surgery from open to laparoscopic, used to be ...

  18. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

    Medline Plus

    Full Text Available ... Loss Surgery: The Fully Robotic Gastric Bypass Baptist Health South Florida Miami, FL May 20, 2010 I ... robotic prostatectomy, which is probably the standard of care today for prostate cancer. This is our eighth ...

  19. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

    Medline Plus

    Full Text Available Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass Baptist Health South Florida Miami, FL May 20, 2010 I am Dr. Anthony Gonzalez, and welcome to South Miami Hospital. We’ ...

  20. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

    Medline Plus

    Full Text Available ... gastrectomy. Another question is, “Does gastric bypass eliminate diabetes?” The morbidly obese patients that we see are those patients that have diabetes mellitus type II, and that’s diabetes associated with ...

  1. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

    Medline Plus

    Full Text Available ... of reinforce this. This has been a really beautiful case. There’s really no bleeding, even though we ... on BAPTISTHEALTH.NET and joining us for this beautiful fully robotic gastric bypass. I hope that Dr. ...

  2. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

    Medline Plus

    Full Text Available ... we have an added dimension, and the depth perception is incredible and just aids the surgery a ... later, there was laparoscopic gastric bypass surgery. The learning curve, which is the time that it takes ...

  3. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

    Medline Plus

    Full Text Available ... gastric bypass. So without further adieu, let me send you out, right outside our doors to my ... everything else that’s going into it, it will send the same signal to the brain that you’ ...

  4. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

    Medline Plus

    Full Text Available ... later, there was laparoscopic gastric bypass surgery. The learning curve, which is the time that it takes ... that you can do it proficiently; however the learning curve with robotic surgery is much shorter. In ...

  5. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

    Medline Plus

    Full Text Available ... done in two dimensions. Here we have an added dimension, and the depth perception is incredible and ... just a restrictive type of procedure. There’s no combined procedure like with the gastric bypass. So the ...

  6. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

    Medline Plus

    Full Text Available ... operative procedure, the live procedure, you’ll understand it. Basically, the gastric bypass works on two different ... a small portion of the stomach and divide it from the rest of the stomach, and that’s ...

  7. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

    Medline Plus

    Full Text Available ... doing robotic gastric bypasses, we would do a hybrid. We would do part of it laparoscopically and ... if they’re using the robot, it’s a hybrid procedure. But now we’re doing them fully ...

  8. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

    Medline Plus

    Full Text Available ... that we see are those patients that have diabetes mellitus type II, and that’s diabetes associated with obesity. And there’s no question that ... The other question is, “Does gastric bypass eliminate diabetes and does the sleeve?” It’s not the type of -- it’s not actually the type of procedure ...

  9. Laparoscopic gastric bypass to robotic gastric bypass: time and cost commitment involved in training and transitioning an academic surgical practice.

    Science.gov (United States)

    Lyn-Sue, Jerome R; Winder, Josh S; Kotch, Shannon; Colello, Jacob; Docimo, Salvatore

    2016-06-01

    The Roux-en-Y gastric bypass is the gold standard procedure for weight loss. This relatively complex procedure has excellent outcomes when performed via laparoscopy. The advent of the DaVinci robotic platform has been a technological advancement. Our goal is to provide information regarding the cost, time commitment, and advantages of transitioning an LRYGB program to an RRYGB program in an academic setting. We retrospectively reviewed the last 25 laparoscopic gastric bypass procedures and the first 25 robotic gastric bypass procedures performed by a single surgeon. We compared clinical outcomes and focused on time and hospital cost during this transition phase. There was no significant demographic difference between the groups. The mean age was 41.7 (RRYGB) years vs 43.4 (LRYGM) years. The mean BMI were similar between groups, 45.3 vs 46.5 kg/m(2) for RRYGB and LRYGB. No anastomotic leaks or mortalities were noted. There was one anastomotic stricture in both groups. Excess weight loss was similar in both groups at 1 year. There was a significant increase in operative time with RRYGB, mean 241 min vs mean 174 min (p = 0.0005). Operative time fell by 25 min after the first 10 cases. The hospital cost was also increased with RRYGB mean $5922 vs $4395 (p = 0.03). Transitioning from a laparoscopic to a robotic practice can be done safely, however, the initial operative times were longer and the hospital cost was higher for robotic gastric bypass. We hope in the future that these will decrease after overcoming the learning and as the technology becomes widespread. PMID:26983848

  10. The Gastric Remnant in Roux-en-Y Gastric Bypass: Challenges and Possibilities.

    Science.gov (United States)

    Mala, Tom

    2016-08-01

    Laparoscopic Roux-en-Y gastric bypass (RYGB) is widely applied in the treatment of morbid obesity. Health personnel meeting these patients should thus be familiar with the potential clinical consequences of the modified anatomy induced by the surgery. After a RYGB, the stomach is left in situ after the closure of the upper part of the organ. This blind-ended gastric remnant may cause complications and surgical emergencies, but also opportunities for diagnostic and therapeutic intervention. The present review focuses on complications related to the gastric remnant including bleeding and acute dilatation in the early postoperative period and later adverse events such as gastroduodenal peptic disease, tumors, gastrogastric fistulas, and late dilatation. Opportunities offered by the remnant, including minimal invasive or open access for enteral nutrition, and therapeutic and diagnostic access to the bile ducts, the duodenum, and the gastric remnant, which is challenged by the modified anatomy, are discussed. Reversal of the gastric bypass and gastrointestinal reconstruction after esophageal resection have been commented on. The review aims to improve the awareness of issues related to the gastric remnant for physicians involved in the treatment and the follow-up of patients after a RYGB. PMID:27203428

  11. [Dealing with surgical complications after bariatric gastric bypass surgery].

    Science.gov (United States)

    Schlesinger, Nis Hallundbæk; Naver, Lars

    2013-11-25

    The subject of this article is surgical complications to Roux-en-Y-gastric bypass and how to deal with them. The article addresses doctors, who are on duty in hospitals without bariatric surgery and who often deal with this patient category in the acute situation. Managing complications is challenging due to both the patient's physiognomy and the wide-ranged change in anatomy. The article gives a review of the literature and hands-on-recommendations for treating anastomotic leak, post-operative bleeding, internal herniation, bowel obstruction and biliary complications. PMID:24629437

  12. ROBOTIC ROUX-EN-Y GASTRIC BYPASS: OPERATIVE RESULTS IN 100 PATIENTS

    OpenAIRE

    DOMENE, Carlos Eduardo; VOLPE, Paula; HEITOR, Frederico A.

    2014-01-01

    Background Laparoscopic gastric bypass is gold-standard for morbid obesity treatment. Aim To describe the results of robotic gastric bypass for morbid obesity patients. Method Were operated on 100 morbidly obese patients through totally robotic gastric bypass between 2013 and 2014. They were 83% female. The age ranged from 20 to 65 years old (medium 48,5 years); the body mass index varied between 38-67 (medium 42,3 kg/cm2). The procedure was designed with 3 cm long gastric pouch, 1 m biliopan...

  13. Severe scurvy after gastric bypass surgery and a poor postoperative diet

    DEFF Research Database (Denmark)

    Hansen, Esben P K; Metzsche, Carsten; Henningsen, Emil;

    2012-01-01

    After bariatric gastric bypass surgery patients are at risk of developing micronutrient deficiencies. If gastric bypass surgery is followed by a vitamin deficient diet the patients have a risk of developing vitamin-C deficiency. When spontaneous ecchymosis is observed in the skin, in at-risk pati......-risk patients, scurvy must be considered. When treated with large doses of vitamin-C the symptoms of scurvy rapidly improve even if the patient has developed multiple organ dysfunction syndrome. KEYWORDS: Scurvy; Gastric bypass surgery; Multiorgan dysfunction....

  14. Severe Scurvy After Gastric Bypass Surgery and a Poor Postoperative Diet

    OpenAIRE

    Hansen, Esben P.K.; Metzsche, Carsten; Henningsen, Emil; Toft, Palle

    2012-01-01

    After bariatric gastric bypass surgery patients are at risk of developing micronutrient deficiencies. If gastric bypass surgery is followed by a vitamin deficient diet the patients have a risk of developing vitamin-C deficiency. When spontaneous ecchymosis is observed in the skin, in at-risk patients, scurvy must be considered. When treated with large doses of vitamin-C the symptoms of scurvy rapidly improve even if the patient has developed multiple organ dysfunction syndrome. Keywords Scurv...

  15. Pregnancy following gastric bypass surgery (Roux-en-Y) for morbid obesity

    OpenAIRE

    Anasiudu, R; Gajjar, K; Osoba, O; Soliman, N

    2011-01-01

    Morbidly obese women are at increased risk of obstetric complications and poor neonatal outcomes. Gastric bypass surgery is being performed with increased frequency in reproductive-aged women to treat morbid obesity. Both maternal and fetal complications have been reported in women who underwent gastric bypass surgery. Current recommendations advise delaying pregnancy for at least 1 year following bariatric surgery. This guideline is meant to discourage women from becoming pregnant during the...

  16. Anti-Obesity and Anti-Hyperglycemic Effects of Cinnamaldehyde via altered Ghrelin Secretion and Functional impact on Food Intake and Gastric Emptying

    OpenAIRE

    Camacho, Susana; Michlig, Stephanie; De Senarclens-Bezencon, Carole; Meylan, Jenny; Meystre, Julie; Pezzoli, Maurizio; Markram, Henry; le Coutre, Johannes

    2015-01-01

    Cinnamon extract is associated to different health benefits but the active ingredients or pathways are unknown. Cinnamaldehyde (CIN) imparts the characteristic flavor to cinnamon and is known to be the main agonist of transient receptor potential-ankyrin receptor 1 (TRPA1). Here, expression of TRPA1 in epithelial mouse stomach cells is described. After receiving a single-dose of CIN, mice significantly reduce cumulative food intake and gastric emptying rates. Co-localization of TRPA1 and ghre...

  17. Substance misuse following Roux-en-Y gastric bypass surgery.

    Science.gov (United States)

    Reslan, Summar; Saules, Karen K; Greenwald, Mark K; Schuh, Leslie M

    2014-03-01

    Post-bariatric surgery patients are overrepresented in substance abuse treatment, particularly those who have had the Roux-en-Y gastric bypass (RYGB) procedure. The severity of the substance use disorder (SUD; i.e., warranting inpatient treatment) and related consequences necessitate a better understanding of the variables associated with post-RYGB SUDs. This investigation assessed factors associated with post-RYGB substance misuse. Post-RYGB patients (N = 141; at least 24 months postsurgery) completed an online survey assessing variables hypothesized to contribute to post-RYGB SUDs. Fourteen percent of participants met criteria for postoperative substance misuse. Those with a lower percent total weight loss (%TWL) were more likely to endorse substance misuse. Family history of substance misuse was strongly associated with postoperative substance misuse. Eating-related variables including presurgical food addiction and postsurgical nocturnal eating, subjective hunger, and environmental responsiveness to food cues were also associated with a probable postoperative SUD. These findings have clinical utility in that family history of substance misuse can be easily assessed, and at-risk patients can be advised accordingly. In addition, those who endorse post-RYGB substance misuse appear to have stronger cognitive and behavioral responses to food, providing some support for the theory of behavioral substitution (or "addiction transfer"). PMID:24102253

  18. Postprandial diabetic glucose tolerance is normalized by gastric bypass feeding as opposed to gastric feeding and is associated with exaggerated GLP-1 secretion

    DEFF Research Database (Denmark)

    Dirksen, Carsten; Hansen, Dorte L; Madsbad, Sten; Hvolris, Lisbeth E; Naver, Lars S; Holst, Jens Juul; Worm, Dorte

    2010-01-01

    OBJECTIVE: To examine after gastric bypass the effect of peroral versus gastroduodenal feeding on glucose metabolism. RESEARCH DESIGN AND METHODS: A type 2 diabetic patient was examined on 2 consecutive days 5 weeks after gastric bypass. A standard liquid meal was given on the first day into the...

  19. Copper Deficiency after Gastric Bypass for Morbid Obesity: a Systematic Review.

    Science.gov (United States)

    Kumar, Parveen; Hamza, Numan; Madhok, Brijesh; De Alwis, Nimantha; Sharma, Manisha; Miras, Alexander Dimitri; Mahawar, Kamal K

    2016-06-01

    A large number of patients undergoing bariatric surgery are deficient in copper, and Roux-en-Y gastric bypass can further aggravate it. Delays in diagnosis and treatment of copper deficiency can leave patients with residual neurological disability. This has led to recommendation from the British Obesity and Metabolic Surgery Society that copper levels should be monitored annually after gastric bypass. This review concludes that copper deficiency in adequately supplemented patients is rare and can be adequately treated if a related haematological or neurological disorder is diagnosed. The cost of routine monitoring may therefore not be justified for adequately supplemented, asymptomatic patients who have undergone Roux-en-Y gastric bypass. The screening may however be necessary for high-risk patient groups to prevent severe complications and permanent disability. PMID:27034062

  20. Laparoscopic Revision of an Omega Loop Gastric Bypass to Treat Afferent Loop Syndrome.

    Science.gov (United States)

    Kassir, Radwan; Blanc, Pierre; Lointier, Patrice; Breton, Christophe; Debs, Tarek; Tiffet, Olivier

    2015-10-01

    The omega loop gastric bypass (OLGB) has become a very commonly performed bariatric procedure because of the advantages it carries over the Roux en Y gastric bypass (RYGBP). However, mini gastric bypass is a misnomer, as this procedure is more malabsorptive than the RYGBP. Recently, it is called single or one anastomosis gastric bypass. The omega loop procedure is associated with a risk of afferent loop syndrome, a known complication of the Billroth II (Finsterer) operation. This rare complication of the OLGB can be debilitating, serious, and deadly. Afferent loop syndrome should be suspected in case of malabsorption syndrome with chronic diarrhea, steatorrhea, iron-deficiency anemia, edema, emaciation, and osteomalacia and also in case of simple biological anomalies such as macrocytosis or megaloblastic anemia. The diagnosis can be confirmed by measuring bacterial overgrowth, although this requires a jejunal aspirate performed during endoscopy with jejunal intubation. A microbial population of more than 106 organisms per milliliter of aspirate is pathological. Afferent loop syndrome is encountered less frequently now that the number of gastrectomies has dropped. Yet, with the omega loop bypass procedure becoming more common, surgeons must again be made aware of this potential complication. PMID:26210192

  1. Reversible hyperinsulinemic hypoglycemia after gastric bypass: a consequence of altered nutrient delivery

    DEFF Research Database (Denmark)

    McLaughlin, Tracey; Peck, Marcia; Holst, Jens; Deacon, Carolyn

    2010-01-01

    Severe hypoglycemia after Roux-en-Y gastric bypass surgery (RYGB) is an increasingly recognized condition, characterized by neuroglycopenia and inappropriately elevated insulin concentrations that occur primarily in the postprandial state. Both pathophysiology and treatment of this disorder remai...... elusive, but it has been postulated that hyperplasia and/or hypertrophy of beta-cells due to morbid obesity and/or postsurgical nesidioblastosis may contribute.......Severe hypoglycemia after Roux-en-Y gastric bypass surgery (RYGB) is an increasingly recognized condition, characterized by neuroglycopenia and inappropriately elevated insulin concentrations that occur primarily in the postprandial state. Both pathophysiology and treatment of this disorder remain...

  2. Nutritional and Protein Deficiencies in the Short Term following Both Gastric Bypass and Gastric Banding.

    Directory of Open Access Journals (Sweden)

    Judith Aron-Wisnewsky

    Full Text Available The number of morbidly obese patients undergoing bariatric surgery (BS has increased dramatically in recent years. Therefore, monitoring food intake and its consequences in terms of nutritional status is necessary to prevent nutritional deficiencies. The aim of this study was to analyze the effect of food restriction on nutritional parameters in the short-term (≤3 months period after BS in morbid obesity.In a prospective study, we followed 22 obese women who underwent Roux-en-Y gastric bypass (GBP or adjustable gastric banding (AGB at baseline (T0 and 1 (T1 and 3 (T3 months after surgery. We evaluated food intake, nutrient adequacy and serum concentrations of vitamins and minerals known to be at risk for deficiency following BS.Before surgery, we observed suboptimal food intakes, leading to a risk of micronutrient deficiencies. Serum analysis confirmed nutritional deficiencies for iron and thiamine for 27 and 23% of the patients, respectively. The drastic energy and food reduction seen in the short term led to very low probabilities of adequacy for nutrients equivalent across both surgeries. Serum analysis demonstrated a continuous decrease in prealbumin during the follow-up, indicating mild protein depletion in 21 and 57% of GBP patients and 50 and 63% of AGB patients, respectively, at T1 and T3. Regarding vitamins and minerals, systematic supplementation after GBP prevented most nutritional deficiencies. By contrast, AGB patients, for whom there is no systematic supplementation, developed such deficiencies.Our results suggest that cautious monitoring of protein intake after BS is mandatory. Furthermore, AGB patients might also benefit from systematic multivitamin and mineral supplementation at least in the short term.

  3. Gastric bypass surgery: Improving psoriasis through a GLP-1-dependent mechanism?

    DEFF Research Database (Denmark)

    Faurschou, Annesofie; Zachariae, Claus; Skov, Lone; Vilsbøll, Tina; Knop, Filip K

    2011-01-01

    surgery. This most likely contributes importantly to the acute remission of type 2 diabetes, which is often induced by gastric bypass operations. The hormone is not hypersecreted after the purely restrictive bariatric procedure gastric banding and no case reports exist on improvement in psoriasis......Psoriasis is a common inflammatory skin disease and obesity constitutes a risk factor for the disease. Obese patients with psoriasis are often more difficult to treat and are at increased risk for dyslipidemia, diabetes, hypertension and cardiovascular disease. Case reports suggest that gastric...

  4. Pancreaticoduodenectomy in Patients with a History of Roux-en Y Gastric Bypass Surgery

    Directory of Open Access Journals (Sweden)

    Jeffrey M Hardacre

    2009-03-01

    Full Text Available Context Roux-en Y gastric bypass surgery is the most common operation for treatment of morbid obesity. The approach to pancreaticoduodenal resection in patients with a history of Roux-en Y gastric bypass is not well described. Case reports Pancreaticoduodenal resection was performed in two patients with distal bile duct strictures, with a past history of Roux-en Y gastric bypass. In both cases the remnant stomach, distal bile duct, duodenum and pancreas were excised. The biliopancreatic limb was divided close to the ligament of Treitz and brought up into the supracolic compartment in a retromesenteric manner and pancreatic and biliary anastomoses performed. The previous enteroenterostomy and gastrojejunal anastomoses were left intact. Both patients had an uncompleted post-operative recovery. The mean operating time was 6.5 hours and mean estimated blood loss was 525 mL. They were discharged home by days 6 and 7 post-operatively. Conclusions Pancreaticoduodenal resection can be successfully performed following Roux-en Y gastric bypass with en-bloc excision of the remnant stomach, with the pancreas and bile duct anastomosed to the divided biliopancreatic limb.

  5. Oral bioavailability of moxifloxacin after Roux-en-Y gastric bypass surgery

    NARCIS (Netherlands)

    De Smet, Julie; Colin, Pieter; De Paepe, Peter; Ruige, Johannes; Batens, Helene; Van Nieuwenhove, Yves; Vogelaers, Dirk; Blot, Stijn; Van Bocxlaer, Jan; Van Bortel, Luc M.; Boussery, Koen

    2012-01-01

    Objectives: Roux-en-Y gastric bypass surgery is the most commonly performed procedure for the treatment of morbid obesity. This anatomical alteration may affect the absorption and consequently the bioavailability of oral drugs. This study aims to investigate the oral bioavailability of moxifloxacin

  6. Drug disposition and modelling before and after gastric bypass: immediate and controlled-release metoprolol formulations

    OpenAIRE

    Gesquiere, Ina; Darwich, Adam S; Van der Schueren, Bart; de Hoon, Jan; Lannoo, Matthias; Matthys, Christophe; Rostami, Amin; Foulon, Veerle; Augustijns, Patrick

    2015-01-01

    The aim of the present study was to evaluate the disposition of metoprolol after oral administration of an immediate and controlled-release formulation before and after Roux-en-Y gastric bypass (RYGB) surgery in the same individuals and to validate a physiologically based pharmacokinetic (PBPK) model for predicting oral bioavailability following RYGB.

  7. Iron Deficiency After Roux-en-Y Gastric Bypass: Insufficient Iron Absorption from Oral Iron Supplements

    OpenAIRE

    Gesquiere, Ina; Lannoo, Matthias; Augustijns, Patrick; Matthys, Christophe; Van der Schueren, Bart; Foulon, Veerle

    2014-01-01

    Roux-en-Y gastric bypass (RYGB) may reduce the absorption of iron, but the extent to which this absorption is impeded is largely unknown. First, we determined the prevalence of iron deficiency following RYGB and explored the risk factors for its development. Second, we examined to what extent oral iron supplements are absorbed after RYGB.

  8. Pregnant woman with fatal complication after laparoscopic Roux-en-Y gastric bypass

    DEFF Research Database (Denmark)

    Renault, Kristina; Gyrtrup, Hans Jørgen; Damgaard, Karen;

    2012-01-01

    In Europe, an increasing number of women have bariatric surgery; therefore, obstetricians are likely to encounter these patients. We report a 22-year-old woman, who had previously undergone uncomplicated laparoscopic Roux-en-Y gastric bypass. She was admitted with severe abdominal pain at 35 week...... surgeons experienced in bariatric surgery, as well as radiologists with specific knowledge of relevant imaging procedures....

  9. DIET MICRONUTRIENT ADEQUACY OF WOMEN AFTER 1 YEAR OF GASTRIC BYPASS

    Science.gov (United States)

    LEIRO, Larissa Silveira; Melendez-ARAÚJO, Mariana Silva

    2014-01-01

    Background The more effective treatment for severe obesity is bariatric surgery. Gastric bypass is a surgical technique used worldwide; however, as well as other techniques; it has postoperative risks, including nutrient deficiency. Aim To determine the amounts of dietary iron, calcium, vitamin D and vitamin B12 ingested by patients of a public hospital one year after gastric bypass, and compare with the recommendations of the Recommended Dietary Allowances. Methods This was a transverse descriptive study and the sample consisted of 36 women, with at least one year of gastric bypass. Data collected included sociodemographic, anthropometric and diet variables. Dietetic information was collected through a validated food frequency questionnaire. Ingestion of iron, calcium, vitamin D and vitamina B12 was evaluated in comparison with the Recommended Dietary Allowances, as well as correlation of micronutrient ingestion with time of surgery. Results There was inadequate consumption of iron, calcium and vitamin D. The vitamin B12 intake was considered adequate. There was statistically significant positive correlation between the time of surgery and the ingestion of iron, vitamin B12 and vitamin D. Conclusion The intake of iron, calcium and vitamin D of women one year after gastric bypass was inadequate, emphasizing the importance of multiprofessional monitoring postoperatively to prevent nutrient deficiencies. PMID:25409960

  10. Hematological Disorders following Gastric Bypass Surgery: Emerging Concepts of the Interplay between Nutritional Deficiency and Inflammation

    Directory of Open Access Journals (Sweden)

    Mingyi Chen

    2013-01-01

    Full Text Available Obesity and the associated metabolic syndrome are among the most common and detrimental metabolic diseases of the modern era, affecting over 50% of the adult population in the United States. Surgeries designed to promote weight loss, known as bariatric surgery, typically involve a gastric bypass procedure and have shown high success rates for treating morbid obesity. However, following gastric bypass surgery, many patients develop chronic anemia, most commonly due to iron deficiency. Deficiencies of vitamins B1, B12, folate, A, K, D, and E and copper have also been reported after surgery. Copper deficiency can cause hematological abnormalities with or without neurological complications. Despite oral supplementation and normal serum concentrations of iron, copper, folate, and vitamin B12, some patients present with persistent anemia after surgery. The evaluation of hematologic disorders after gastric bypass surgery must take into account issues unique to the postsurgery setting that influence the development of anemia and other cytopenias. In this paper, the clinical characteristics and differential diagnosis of the hematological disorders associated with gastric bypass surgery are reviewed, and the underlying molecular mechanisms are discussed.

  11. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

    Medline Plus

    Full Text Available ... and are morbidly obese have higher incidents of heart problems. The other things that we see are ... used for multiple surgical procedures. It’s used for heart procedures, the CABG, coronary artery bypass, valve procedures, ...

  12. Effectiveness and safety of laparoscopic Roux-en-Y gastric bypass for the treatment of type 2 diabetes mellitus

    OpenAIRE

    Zhang, Pin; Zhang, Hongwei; Han, Xiaodong; Di, Jianzhong; Zhou, Yulong; Li, Kun; Zheng, Qi

    2016-01-01

    Gastric bypass may be conducted to aid in glycemic control in adults with type 2 diabetes mellitus (T2DM). The aim of the present study was to investigate the clinical results of diabetes remission and metabolic syndrome in individuals with T2DM after undergoing a gastric bypass. A total of 85 patients (39 men and 46 women) with T2DM underwent laparoscopic Roux-en-Y gastric bypass (LRYGB). Data regarding patient demographics, body mass index (BMI), co-morbidities and details of diabetes melli...

  13. Clinical observation of gastric bypass in treatment of type 2 diabetes

    Institute of Scientific and Technical Information of China (English)

    PU Yong-dong; YANG Bo; HE Jiao-miao; WU You-jun; WANG Yi; L(U) Gang; ZHANG Bo; WANG Yue; LIU Wei-ping; WENG Jian-feng; LI Jing-quan; CAO Zhi-yu; WANG Li; HU Xiao; DONG Li-guo; LI Yue-min; ZHAO Hua-zhou; QIN Rong

    2012-01-01

    Background Roux-en-Y gastric bypass (GBP) is the main surgical procedure used in type 2 diabetes.The objective of this study was to evaluate the different types of GBP in treatment of type 2 diabetes.Methods Patients with type 2 diabetes were randomly divided into two groups:those who underwent gastrojejunal loop anastomosis bypass and those who underwent gastrojejunal Roux-en-Y bypass.Blood glucose alterations,operation time,and operation complicatiors were observed.Results Gastrojejunal loop anastomosis bypass and gastrojejunal Roux-en-Y bypass were both effective in the treatment of selected patients with type 2 diabetes.Compared with gastrojejunal Roux-en-Y bypass,gastrojejunal loop anastomosis bypass had the advantages of easier implementation,shorter operation time,and fewer operation complications.Conclusions Gastrojejunal loop anastomosis is effective in treatment of type 2 diabetes.It is safe,easy to implement,and worthy of clinical popularization.

  14. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

    Medline Plus

    Full Text Available ... that’s where the food is going to be traveling. And what the patient is eating will be traveling through the gastric pouch and into the small ... study in 1991 at the National Institute of Health in Washington, D.C. And what they looked ...

  15. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

    Medline Plus

    Full Text Available ... it’s liquid and fluid, and when you’re eating something, the stomach will start to dilate. As ... then the patient is satisfied, and they stop eating. So what we’re doing with the gastric ...

  16. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

    Medline Plus

    Full Text Available ... morning, we’re going to get an upper GI, and the upper GI is going to make sure that the anastomosis ... So tomorrow, after the patient gets an upper GI and everything looks good, the patient’s nasal gastric ...

  17. Treatment of adolescents with morbid obesity with bariatric procedures and anti-obesity pharmacological agents

    Directory of Open Access Journals (Sweden)

    Um SS

    2011-12-01

    Full Text Available Scott S Um1, Wendelin Slusser2, Daniel A DeUgarte11Department of Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA; 2Department of Pediatrics, David Geffen School of Medicine at UCLA, Los Angeles, CA, USAAbstract: Adolescent obesity is a growing health concern that can have immense physical and psychological impact. Treatment of morbidly obese adolescents should include a multidisciplinary team to address medical comorbidities, diet, physical activity, mental health, and behavior modification. Anti-obesity pharmacologic agents have a limited role in the treatment of adolescents because of concerns with side effects, safety, and efficacy. Orlistat (GlaxoSmithKline, Moon Township, PA is the only approved medication for weight-loss in adolescents. However, it is associated with gastrointestinal side effects and its long-term efficacy is unknown. Bariatric surgery is the most effective therapy to treat morbid obesity. However, adolescents must meet rigorous criteria and have appropriate cognitive, psychological, and social clearance before being considered for surgical intervention. Gastric bypass remains the gold standard bariatric operation. The adjustable gastric band is not FDA-approved for use in patients under 18 years of age. Sleeve gastrectomy is a promising procedure for adolescents because it avoids an intestinal bypass and the implantation of a foreign body. Prospective longitudinal assessment of bariatric surgery procedures is required to determine long-term outcomes. In this manuscript, we review the treatment options, efficacy, and impact on quality of life for morbidly obese adolescents.Keywords: bariatric surgery, morbid obesity, weight loss, adolescent

  18. The predictive value of psychological assessment of candidates for gastric bypass: A medical chart review

    OpenAIRE

    Nathalie Aubert; Isabelle Lyon-Pagès; Isabelle Carrard; Michel Suter; Friedrich Stiefel; Vittorio Giusti

    2010-01-01

    Background and Objectives: Guidelines for bariatric surgery demand a psychological evaluation of applicants. The aim of this study was to evaluate if the presence of "psychological risk factors" predicts postoperative weight loss after gastric bypass. Methods: Medical records of obese women who underwent bariatric surgery between 2000 and 2004 were reviewed. Psychological assessment consisted of a one-hour semi-structured interview, summarized in a written report. Anthropometric assessment at...

  19. The predictive value of psychological assessment of candidates for gastric bypass: A medical chart review

    OpenAIRE

    Nathalie Aubert; Isabelle Lyon-Pagès; Isabelle Carrard; Michel Suter; Friedrich Stiefel; Vittorio Giusti

    2010-01-01

    Background and Objectives: Guidelines for bariatric surgery demand a psychological evaluation of applicants. The aim of this study was to evaluate if the presence of "psychological risk factors" predicts postoperative weight loss after gastric bypass. Methods: Medical records of obese women who underwent bariatric surgery between 2000 and 2004 were reviewed. Psychological assessment consisted of a one-hour semi-structured interview, summarized in a written report. Anthropometric assessment...

  20. Mini-gastric bypass to control morbid obesity and diabetes mellitus: What radiologists need to know

    International Nuclear Information System (INIS)

    Laparoscopic mini-gastric bypass surgery is a safe and simple surgical intervention for treating morbid obesity and diabetes mellitus and is now being performed more frequently. Radiologists must be critical in their postoperative evaluation of these patients. In this pictorial review, we explain and illustrate the surgical technique, normal postoperative anatomy, and associated complications as seen on imaging examinations, including fluoroscopy and computed tomography.

  1. Roux-en-Y gastric bypass: effects on feeding behavior and underlying mechanisms

    OpenAIRE

    Manning, Sean; Pucci, Andrea; Batterham, Rachel L.

    2015-01-01

    Bariatric surgery is the most effective treatment for severe obesity, producing marked sustained weight loss with associated reduced morbidity and mortality. Roux-en-Y gastric bypass surgery (RYGBP), the most commonly performed procedure, was initially viewed as a hybrid restrictive-malabsorptive procedure. However, over the last decade, it has become apparent that alternative physiologic mechanisms underlie its beneficial effects. RYGBP-induced altered feeding behavior, including reduced app...

  2. Breath Hydrogen as a Biomarker for Glucose Malabsorption after Roux-en-Y Gastric Bypass Surgery

    OpenAIRE

    Iman Andalib; Hiral Shah; Bal, Bikram S.; Shope, Timothy R.; Finelli, Frederick C.; Koch, Timothy R.

    2015-01-01

    Objective. Abdominal symptoms are common after bariatric surgery, and these individuals commonly have upper gut bacterial overgrowth, a known cause of malabsorption. Breath hydrogen determination after oral glucose is a safe and inexpensive test for malabsorption. This study is designed to investigate breath hydrogen levels after oral glucose in symptomatic individuals who had undergone Roux-en-Y gastric bypass surgery. Methods. This is a retrospective study of individuals (n = 63; 60 females...

  3. Mini-gastric bypass to control morbid obesity and diabetes mellitus: What radiologists need to know

    Energy Technology Data Exchange (ETDEWEB)

    Park, Hyun Jeong [Dept. of Radiology, Chung-Ang University Hospital, Seoul (Korea, Republic of); Hong, Seong Sook; Hwang, Ji Young; Hur, Kyung Yul [Soonchunhyang University Seoul Hospital, Seoul (Korea, Republic of)

    2015-04-15

    Laparoscopic mini-gastric bypass surgery is a safe and simple surgical intervention for treating morbid obesity and diabetes mellitus and is now being performed more frequently. Radiologists must be critical in their postoperative evaluation of these patients. In this pictorial review, we explain and illustrate the surgical technique, normal postoperative anatomy, and associated complications as seen on imaging examinations, including fluoroscopy and computed tomography.

  4. Zinc-deficiency acrodermatitis in a patient with chronic alcoholism and gastric bypass: a case report

    Directory of Open Access Journals (Sweden)

    Dariush Shahsavari

    2014-07-01

    Full Text Available Acquired adult-onset zinc deficiency is occasionally reported in patients with malnutrition states, such as alcoholism, or malabsorptive states, such as post-bariatric surgery. The defining symptoms of hypozincemia include a classic triad of necrolytic dermatitis, diffuse alopecia, and diarrhea. We report a case of zinc deficiency in a 39-year-old man with history of gastric bypass surgery and alcoholism. For this patient, severe hypozincemia confirmed acrodermatitis, and zinc supplementation was met with gradual improvement.

  5. Is bone loss after gastric bypass surgery associated with the extent of weight loss?

    OpenAIRE

    Shapses, Sue A

    2009-01-01

    This Practice Point commentary discusses a prospective study by Fleisher et al. that showed bone loss in response to extreme weight loss in 23 patients following Roux-en-Y gastric bypass surgery. The decline in BMD at the hip, but not at the spine or distal radius, was found to be proportional to the extent of weight loss. Although dietary calcium and vitamin D intake markedly increased after surgery, serum 25 hydroxyvitamin D, serum parathyroid hormone and urinary calcium l...

  6. Changes in Vertebral Bone Marrow Fat and Bone Mass After Gastric Bypass Surgery: A Pilot Study

    OpenAIRE

    Schafer, AL; Li, X; Schwartz, AV; Tufts, LS; Wheeler, AL; Grunfeld, C; Stewart, L; Rogers, SJ; Carter, JT; Posselt, AM; Black, DM; Shoback, DM

    2015-01-01

    Bone marrow fat may serve a metabolic role distinct from other fat depots, and it may be altered by metabolic conditions including diabetes. Caloric restriction paradoxically increases marrow fat in mice, and women with anorexia nervosa have high marrow fat. The longitudinal effect of weight loss on marrow fat in humans is unknown. We hypothesized that marrow fat increases after Roux-en-Y gastric bypass (RYGB) surgery, as total body fat decreases. In a pilot study of 11 morb...

  7. Weight Loss After Laparoscopic Band-to-Bypass Revision Compared With Primary Gastric Bypass: Long-term Outcomes.

    Science.gov (United States)

    Sadot, Eran; Spivak, Hadar

    2015-06-01

    Laparoscopic Roux-en-Y gastric bypass (RYGB) is frequently performed as a salvage operation after failed laparoscopic adjustable gastric banding (LAGB). Reports about long-term outcomes are lacking. We assessed the long-term outcomes of RYGB revision surgery after failed LAGB (study group, n = 44) and compared these outcomes with a demographically matched group who underwent primary RYGB (control group, n = 82). There were no between-group differences in sex distribution, age, or initial weight characteristics. At 2 years after RYGB, the mean ΔBMI was 11.8 ± 5.7 kg/m2 in the study group and 15.6 ± 4.2 kg/m2 in the control group (P = 0.01); the corresponding %EWL values were 57% and 78% (P = 0.005). At 6 years after RYGB, the mean ΔBMI was 10 ± 4.5 kg/m2 in the study group and 13.6 ± 5.7 kg/m2 in the control group (P = 0.006); the corresponding %EWL values were 53% and 66% (P = 0.04). In conclusion, this study supports the safety and favorable weight-loss outcome of LAGB revision to RYGB. However, the results are inferior to those of primary RYGB. PMID:25856132

  8. Radiologic evaluation following Roux-en-Y gastric bypass surgery for morbid obesity

    International Nuclear Information System (INIS)

    Morbid obesity is an increasing health problem, and bariatric surgery is becoming a popular treatment option. Radiologists must be familiar with performing and interpreting studies in this patient population. The typical postoperative findings of the Roux-en-Y gastric bypass (RYGBP) procedure for morbid obesity on upper gastrointestinal (UGI) series are presented. An overview of the potential complications that may be diagnosed with contrast studies and computed tomography (CT) is provided in addition to a description of potential pitfalls in interpreting these studies

  9. Radiologic evaluation following Roux-en-Y gastric bypass surgery for morbid obesity

    Energy Technology Data Exchange (ETDEWEB)

    Carucci, Laura R. [Department of Radiology, Virginia Commonwealth University Medical Center, P.O. Box 980615, Richmond, VA 23298-0615 (United States)]. E-mail: lcarucci@vcu.edu; Turner, Mary Ann [Department of Radiology, Virginia Commonwealth University Medical Center, P.O. Box 980615, Richmond, VA 23298-0615 (United States)

    2005-03-01

    Morbid obesity is an increasing health problem, and bariatric surgery is becoming a popular treatment option. Radiologists must be familiar with performing and interpreting studies in this patient population. The typical postoperative findings of the Roux-en-Y gastric bypass (RYGBP) procedure for morbid obesity on upper gastrointestinal (UGI) series are presented. An overview of the potential complications that may be diagnosed with contrast studies and computed tomography (CT) is provided in addition to a description of potential pitfalls in interpreting these studies.

  10. Incidence and risk factors for the development of anemia following gastric bypass surgery

    Institute of Scientific and Technical Information of China (English)

    Dimitrios; V; Avgerinos; Omar; H; Llaguna; Matthew; Seigerman; Amanda; J; Lefkowitz; I; Michael; Leitman

    2010-01-01

    AIM:To evaluate the incidence and risk factors for the development of anemia after RouxenY gastric bypass (RYGB).METHODS: A retrospective analysis of patients undergoing RYGB from January 2003 to November 2007 was performed. All patients had a preoperative body mass index > 40 kg/m2. A total of 206 patients were evaluated. All patients were given daily supplements of ferrous sulfate tablets for 2 wk following their operation. Hematological and metabolic indices were routinely evaluated following surgery. Pa...

  11. Gastric bypass alters the dynamics and metabolic effects of insulin and proinsulin secretion

    OpenAIRE

    Johansson, H-E.; Öhrvall, M.; Haenni, A.; Sundbom, M; Edén Engström, B.; Karlsson, F A; Zethelius, B.

    2007-01-01

    Aims Hyperproinsulinaemia is associated with obesity and is a risk factor for Type 2 diabetes. We explored the dynamics of proinsulin and insulin and postprandial effects on glucose and lipids in subjects who had undergone gastric bypass (GBP) surgery compared with morbidly obese (MO) subjects and normal weight control subjects (NW). Methods Subjects free from diabetes were recruited: 10 previously MO subjects [body mass index (BMI)±sd, 34.8±6.2kg/m2] who had undergone GBP surgery, 10 MO subj...

  12. Psychological characteristics and associations with weight outcomes two years after gastric bypass surgery

    DEFF Research Database (Denmark)

    Beck, Nina N; Mehlsen, Mimi; Støving, René Klinkby

    2012-01-01

    This study investigated symptoms of eating disorder, depression, and anxiety among Roux-en-Y gastric bypass patients two years after surgery, and the relationship between these characteristics and weight loss. Respondents completed assessment questionnaires including Eating Disorder Inventory-2...... that knowledge of the potential influence of eating disorder symptoms on outcomes after bariatric surgery is needed in order to optimize weight outcomes following surgery....... (EDI-2), Harvard Anxiety and Depression Scale (HADS), and questions related specifically to binge eating. Forty-five patients (8 men, 37 women) out of 65 (67%) responded. Scores were significant higher on impulse regulation, interoceptive awareness, ineffectiveness, maturity fears and interpersonal...

  13. Accelerated protein digestion and amino acid absorption after Roux-en-Y gastric bypass

    DEFF Research Database (Denmark)

    Bojsen-Møller, Anna Kirstine; Jacobsen, Siv H; Dirksen, Carsten;

    2015-01-01

    BACKGROUND: Roux-en-Y gastric bypass (RYGB) involves exclusion of major parts of the stomach and changes in admixture of gastro-pancreatic enzymes, which could have a major impact on protein digestion and amino acid absorption. OBJECTIVE: We investigated the effect of RYGB on amino acid appearance...... RYGB. CONCLUSIONS: RYGB accelerates caseinate digestion and amino acid absorption, resulting in faster and higher but more transient postprandial elevation of plasma amino acids. Changes are likely mediated by accelerated intestinal nutrient entry and clearly demonstrate that protein digestion is not...

  14. Effect of closure of the mesenteric defect during laparoscopic gastric bypass and prevention of internal hernia

    DEFF Research Database (Denmark)

    Kristensen, Sara Danshøj; Naver, Lars; Jess, Per; Floyd, Andrea Karen

    2014-01-01

    INTRODUCTION: The aim of this study is to evaluate the benefits and disadvantages of closing the mesenteric defects during gastric bypass to avoid internal herniation (IH). MATERIAL AND METHODS: The study is performed as a single-centre, randomised, controlled, blinded trial. Patients are randomly......: The study was registered with the Danish Data Protection Agency (SN-10-2012) and The Central Denmark Regional Committees on Biomedical Research Ethics (1-01-83-0209-12, SJ-284). The study is registered with clinicaltrials.gov: NCT01595230....

  15. GLP1 and glucagon co-secreting pancreatic neuroendocrine tumor presenting as hypoglycemia after gastric bypass

    DEFF Research Database (Denmark)

    Guimarães, Marta; Rodrigues, Pedro; Pereira, Sofia S;

    2015-01-01

    the treatment of severe obesity, a 54-year-old female with previous type 2 diabetes, developed post-prandial sweating, fainting and hypoglycemic episodes, which eventually led to the finding by ultrasound of a 1.8-cm solid mass in the pancreatic head. The 72-h fast test and the plasma chromogranin A......Post-prandial hypoglycemia is frequently found after bariatric surgery. Although rare, pancreatic neuroendocrine tumors (pNET), which occasionally are mixed hormone secreting, can lead to atypical clinical manifestations, including reactive hypoglycemia. Two years after gastric bypass surgery for...

  16. Gastrointestinal complications of bariatric Roux-en-Y gastric bypass surgery

    Energy Technology Data Exchange (ETDEWEB)

    Sandrasegaran, Kumaresan; Rajesh, Arumugam; Lall, Chandana; Maglinte, Dean D. [Indiana University Medical Center, UH 0279, Department of Radiology, Indianapolis, IN (United States); Gomez, Gerardo A. [Wishard Memorial Hospital, Department of Surgery, Indianapolis (United States); Lappas, John C. [Wishard Memorial Hospital, Department of Radiology, Indianapolis (United States)

    2005-02-01

    Obesity is rapidly becoming the most important public health issue in USA and Europe. Roux-en-Y gastric bypass is now established as the gold standard for treating intractable morbid or super obesity. We reviewed the imaging findings following this surgery in 234 patients. In this pictorial essay we present the CT and upper gastrointestinal contrast study appearances of the expected postoperative anatomy as well as a range of abdominal complications. The complications are classified into leaks, fistula and obstruction. Postoperative gastric outlet and small bowel obstruction can be caused by anastomotic stenosis, mesocolic tunnel stenosis, adhesions, stomal ulcer, obturation, intussusception and internal or external hernia. Small bowel obstruction may be of a simple, closed loop and/or strangulating type. The radiologist should be able to diagnose the type and possible cause of obstruction. (orig.)

  17. Gastrointestinal complications of bariatric Roux-en-Y gastric bypass surgery

    International Nuclear Information System (INIS)

    Obesity is rapidly becoming the most important public health issue in USA and Europe. Roux-en-Y gastric bypass is now established as the gold standard for treating intractable morbid or super obesity. We reviewed the imaging findings following this surgery in 234 patients. In this pictorial essay we present the CT and upper gastrointestinal contrast study appearances of the expected postoperative anatomy as well as a range of abdominal complications. The complications are classified into leaks, fistula and obstruction. Postoperative gastric outlet and small bowel obstruction can be caused by anastomotic stenosis, mesocolic tunnel stenosis, adhesions, stomal ulcer, obturation, intussusception and internal or external hernia. Small bowel obstruction may be of a simple, closed loop and/or strangulating type. The radiologist should be able to diagnose the type and possible cause of obstruction. (orig.)

  18. Investigation of the excluded stomach after Roux-en-Y gastric bypass: The role of percutaneous endoscopy

    Institute of Scientific and Technical Information of China (English)

    Kanwar RS Gill; J Mark McKinney; Mark E Stark; Ernest P Bouras

    2008-01-01

    Accessing the bypassed portion of the stomach via conventional endoscopy is difficult following Roux-en-Y gastric bypass surgery. However, endoscopic examination of the stomach and small bowel is possible through percutaneous access into the bypassed stomach (BS) with a combined radiologic and endoscopic technique. We present a case of obscure overt gastrointestinal (GI) bleeding where the source of bleeding was thought to be from the BS. After conventional endoscopic methods failed to examine the BS, percutaneous endoscopy (PE) was used as an alternative to surgical exploration.

  19. Outcome of gastroplasty and gastric bypass in a single centre in the UK

    Directory of Open Access Journals (Sweden)

    Sintler M

    2009-09-01

    Full Text Available Abstract Background Morbid obesity is defined as BMI>40 kg/m2. It affects 124,000 men and 412,000 women in England and Wales (NICE, July 2002. According to NICE guidelines, Bariatric surgery is indicated if the treatments for obesity such as exercise, diet and drugs fail. Procedures include laparoscopic gastric banding (LGB, vertical banded gastroplasty (VBG, and Gastric Bypass (GB. Aims The aim of this audit was to determine if NICE guidelines on the use of Bariatric surgery in the Manor Hospital, Walsall was being adhered to. Secondary aims were also to establish if Bariatric surgery is achieving its goal in the long-term and if weight reduction is being maintained in this group of patients. Methods A retrospective cohort study was carried out on patients who underwent Bariatric surgery between 1990 and 2004. Retrieved records were scrutinised and the following parameters were collated: pre-operative morbidities, intra and post-operative complication rates and weight reduction on follow-up. Results 129 patients were operated on in the 14 year period. For VBG, 40 out of 105 patients had weight gain by the 5th follow-up visit. This compared with 5 out of 18 patients after the same timescale for the GB group and 1 out of 6 in the LGB group. The most common post-operative complication was stenosis (28% of VBG group. Conclusion Bariatric surgery is relatively safe as an intervention for morbid obesity. Weight loss however is not maintained in the long term. VBG and LGB are short term interventions. Further research is required to look into the merits of gastric bypass surgery.

  20. Safety Evaluation of Laparoscopic Sleeve Gastrectomy Compared with Two Procedures of Laparoscopic Roux-en-Y Gastric Bypass and Laparoscopic Adjustable Gastric Banding for Individuals with Morbid Obesity: A Systemic Review

    Directory of Open Access Journals (Sweden)

    F Arabi Basharic

    2015-10-01

    Full Text Available Introduction: Laparoscopic Roux-en-Y gastric bypass and laparoscopic adjustable gastric banding are the most common bariatric surgery procedures. Therefore, this study aims to compare the safety of the newer procedure of Laparoscopic sleeve gastrectomy compared to Laparoscopic Roux-en-Y gastric bypass and Laparoscopic adjustable gastric bonding. Method: A systematic review was conducted on the most important and most relevant search data bases, including Cochrane library, Pubmed, Ovid Medline as well as Iranian sites of Magiran , Iranmedex , SID, not taking the time limit into consideration. The results found in the literature were classified and were then analyzed. Results: Out of 384 articles obtained in the search, 4 randomized clinical trials (RCT were included in this study. There were no reports of death comparing surgical procedures of Roux-en-Y gastric bypass and sleeve gastrectomy. Moreover, in adjustable gastric banding and Roux-en-Y gastric bypass comparison, one death was observed in each group. Regarding the side effects of Roux-en-Y gastric bypass and sleeve gastrectomy, 10% early complications were reported in the Roux-en-Y gastric  bypass group , and 13% were observed in the sleeve gastrectomy group between which no statistically significant difference was revealed. The comparison between adjustable gastric banding and Roux-en-Y gastric bypass demonstrated that the occurrence of early and late complications was reported to be higher in the gastric bypass group, though no statistically significant difference was observed. Conclusion: The present study findings demonstrated no statistically significant difference between these methods in regard with the safety aspect. As a result, selection as well as success of the bariatric surgery procedures depend on the patient's and surgeon's preferences.

  1. Attachment Anxiety Predicts Poor Adherence to Dietary Recommendations : an Indirect Effect on Weight Change 1 Year After Gastric Bypass Surgery

    NARCIS (Netherlands)

    Aarts, Floor; Geenen, Rinie; Gerdes, Victor E. A.; van de Laar, Arnold; Brandjes, Dees P. M.; Hinnen, Chris

    2015-01-01

    Weight loss after gastric bypass surgery depends on the adoption of healthy dietary recommendations, which may be influenced by psychological issues and patients' attachment representations (habitual states of mind with respect to interpersonal relations). The present study tests (1) whether attachm

  2. Attachment anxiety predicts poor adherence to dietary recommendations : an indirect effect on weight change 1 year after gastric bypass surgery

    NARCIS (Netherlands)

    Hinnen, C.; Aarts, F.; Geenen, R.

    2014-01-01

    BACKGROUND: Weight loss after gastric bypass surgery depends on the adoption of healthy dietary recommendations, which may be influenced by psychological issues and patients' attachment representations (habitual states of mind with respect to interpersonal relations). The present study tests (1) whe

  3. Attachment anxiety predicts poor adherence to dietary recommendations : an indirect effect on weight change one year after gastric bypass surgery

    NARCIS (Netherlands)

    Aarts, F.; Geenen, R.; Gerdes, V.E.A.; Van de Laar, A., A.; Brandjes, D.P.M.; Hinnen, C.

    2015-01-01

    BACKGROUND: Weight loss after gastric bypass surgery depends on the adoption of healthy dietary recommendations, which may be influenced by psychological issues and patients' attachment representations (habitual states of mind with respect to interpersonal relations). The present study tests (1) whe

  4. Life threatening bleeding from duodenal ulcer after Roux-en-Y gastric bypass: Case report and review of the literature

    Institute of Scientific and Technical Information of China (English)

    Arpad; Ivanecz; Marko; Sremec; Davorin; ?erani?; Stojan; Potr?; Pavel; Skok

    2014-01-01

    Acute upper gastrointestinal bleeding is a rare, but serious complication of gastric bypass surgery. The inaccessibility of the excluded stomach restrains postoperative examination and treatment of the gastric remnant and duodenum, and represents a major challenge, especially in the emergency setting. A 59-year-old patient with previous history of peptic ulcer disease had an upper gastrointestinal bleeding from a duodenal ulcer two years after having a gastric bypass procedure for morbid obesity. After negative upper endoscopy finding, he was urgently evaluated for gastrointestinal bleeding. At emergency laparotomy, the bleeding duodenal ulcer was identified by intraoperative endoscopy through gastrotomy. The patient recovered well after surgical hemostasis, excision of the duodenal ulcer and completion of the remnant gastrectomy. Every general practitioner, gastroenterologist and general surgeon should be aware of growing incidenceof bariatric operations and coherently possible complications after such procedures, which modify patient’s anatomy and physiology.

  5. Longer-Term Physiological and Metabolic Effects of Gastric Bypass Surgery.

    Science.gov (United States)

    Mosinski, J David; Kirwan, John P

    2016-06-01

    Obesity is closely associated with the development of type 2 diabetes. Many strategies have been used in the past to combat these two conditions, but very few provide for stable and durable glycemic control. Bariatric surgery has emerged as a powerful tool for treating obesity and in over 70 % of cases provides a short-term cure for diabetes. While the acute metabolic effects of surgery are striking, it remains important for us to also consider the long-term effects. This review aims to summarize the chronic or long-term metabolic and physiological effects of Roux-en-Y gastric bypass (RYGB) surgery on pancreatic function, skeletal muscle and hepatic insulin sensitivity, and gastrointestinal remodeling. An increased understanding of the current state of research in these areas can provide the basis for stimulating further research that would contribute to new treatment and management strategies for obesity and diabetes. PMID:27091444

  6. Improvement in health-related quality of life following Roux-en-Y gastric bypass

    DEFF Research Database (Denmark)

    Hansen, Nina Beck; Gudex, Claire; Støving, René Klinkby

    2014-01-01

    INTRODUCTION: This study explored whether health-related quality of life (HRQOL) changes following Roux-en-Y gastric bypass surgery were associated with identifiable socio-demographic or clinical characteristics, and it examined the impact on health outcomes of changes in the Danish criteria for...... bariatric surgery. MATERIAL AND METHODS: Participants (n = 55) completed the Short Form Health Survey v2 (SF-36) before and 22 ± 4.2 months after surgery. Information on socio-demographics, body mass index (BMI), co-morbidity and satisfaction with surgery were collected through patient questionnaires and...... hospital records. RESULTS: There was overall improvement on all SF-36 subscales and in the mean physical score (PCS) and mean mental score (MCS) (p = 0.001). A total of five patients had lower PCS and 13 patients had lower MCS after surgery, but we identified no particular characteristics associated with...

  7. Laparoscopic Roux-en-Y gastric bypass in super obese Göttingen minipigs

    DEFF Research Database (Denmark)

    Birck, Malene Muusfeldt; Vegge, Andreas; Støckel, Mikael; Gögenür, Ismayil; Thymann, Thomas; Hammelev, Karsten Pharao; Sangild, Per Torp; Hansen, Axel Jacob Kornerup; Raun, Kirsten; von Voss, Pia; Eriksen, Thomas

    2013-01-01

    Background: The specific mechanisms behind weight loss and comorbidity improvements in obese patients after Roux-en-Y gastric bypass (RYGBP) are still poorly understood. The aim of this study was to establish and evaluate the feasibility of a long-term survival RYGBP model in super obese Göttingen...... minipigs in order to improve the translational potential relative to current animal models. Methods: Eleven Göttingen minipigs with diet-induced obesity underwent laparoscopic RYGBP and were followed up to 9 months after surgery. Intra-and post-operative complications, body weight (BW), food intake and...... necropsy data were recorded. Results: Five minipigs survived without complications to the end of the study. Four minipigs developed surgical related complications and were euthanized while two minipigs died due to central venous catheter related complications. BW and food intake is reported for the six...

  8. Enhanced insulin signaling in human skeletal muscle and adipose tissue following gastric bypass surgery

    DEFF Research Database (Denmark)

    Albers, Peter H; Bojsen-Møller, Kirstine N; Dirksen, Carsten;

    2015-01-01

    Roux-en-Y gastric bypass (RYGB) leads to increased peripheral insulin sensitivity. The aim of this study was to investigate the effect of RYGB on expression and regulation of proteins involved in regulation of peripheral glucose metabolism. Skeletal muscle and adipose tissue biopsies from glucose...... and glycogen synthase activity were enhanced 12 months post-surgery. In adipose tissue, protein expression of GLUT4, Akt2, TBC1D4 and acetyl-CoA carboxylase (ACC), phosphorylated levels of AMP-activated protein kinase and ACC as well as insulin-induced changes in phosphorylation of Akt and TBC1D4 were...... enhanced 12 months post-surgery. Adipose tissue from glucose tolerant subjects was the most responsive to RYGB compared to type 2 diabetic patients, whereas changes in skeletal muscle were largely similar in these two groups. In conclusion, an improved molecular insulin sensitive phenotype of skeletal...

  9. Effects of Roux-en-Y Gastric Bypass on Energy Expenditure and Appetite

    DEFF Research Database (Denmark)

    Schmidt, Julie Berg

    that gastric bypass (GBP) surgery attenuates these processes, explaining the superiority of this weight loss intervention. However, the effect of GBP on EE has never been investigated independently of acute changes in energy balance. After GBP, decreased motivation to eat coincides with hormonal......, and whether it particularly affects meal-induced thermogenesis merits further investigation.In spite of progressive weight loss, GBP decreased motivation to eat. This effect was partly explained by a simultaneous postprandial increase in GLP-1, a suppression of ghrelin, an increase in nausea, and to a...... lesser extent, an increase in PYY. Leptin and CCK, however, were not involved in reductions in motivation to eat after GBP. When GLP-1 and PYY were coinfused, the eduction in energy intake clearly exceeded the summed effects of the ormones when given separately. This suggests a synergistic effect, which...

  10. Bone Structural Changes and Estimated Strength After Gastric Bypass Surgery Evaluated by HR-pQCT

    DEFF Research Database (Denmark)

    Frederiksen, Katrine Diemer; Hanson, Stine; Hansen, Stinus;

    2016-01-01

    Roux-en-Y gastric bypass surgery (RYGB) is an effective treatment of morbid obesity, with positive effects on obesity-related complications. The treatment is associated with bone loss, which in turn might increase fracture risk. The aim of this study was to evaluate changes in bone mineral density...... patients (10 males, 15 females). Patients were examined with DXA of the hip and spine, HR-pQCT of radius and tibia, and blood sampling before and 6 and 12 months after RYGB. Patients lost in average 33.5 ± 12.1 kg (25.8 ± 8.5 %) in 12 months. In tibia, we found significant loss of total, cortical and...... increased risk of fracture in bariatric patients after surgery. We only observed bone structural changes in the weight-bearing bone, which indicates that mechanical un-loading is the primary mediator....

  11. Prevalence of Self-reported Symptoms After Gastric Bypass Surgery for Obesity

    DEFF Research Database (Denmark)

    Gribsholt, Sigrid Bjerge; Pedersen, Ane Mathilde; Svensson, Elisabeth;

    2016-01-01

    Importance: Population-based studies on the prevalence of symptoms after Roux-en-Y gastric bypass (RYGB) surgery are sparse. Knowledge about possible predictors of these symptoms is important for prevention. Objectives: To examine patients' overall well-being and the prevalence and predictors of...... [34.2%]), fatigue (488 [34.1%]), and anemia (396 [27.7%]). The risk of symptoms was higher among women (crude PR, 1.23; 95% CI, 1.11-1.37), among patients younger than 35 years (PR, 1.24; 95% CI, 1.13-1.36), among smokers (PR, 1.11; 95% CI, 1.02-1.20), among unemployed persons (PR, 1.15; 95% CI, 1...

  12. Internal hernia in late pregnancy after laparoscopic Roux-en-Y gastric bypass.

    Science.gov (United States)

    Gruetter, Florian; Kraljević, Marko; Nebiker, Christian A; Delko, Tarik

    2014-01-01

    A 27-year-old patient in late pregnancy presented to the department of obstetrics with crampy abdominal pain located in the right flank, 3 years after a laparoscopic Roux-en-Y gastric bypass. Clinical investigation showed tenderness on palpation in the upper abdomen without signs of peritonitis. The cardiotocogram and blood tests were normal. The ultrasound showed a hydronephrosis on the right side, and a pigtail catheter was inserted. The abdominal symptoms did not abate and the abdominal surgeon was consulted 36 hours after admission. Diagnostic laparoscopy was performed promptly because of high suspicion of internal hernia (IH). Laparoscopy showed IH at the mesojejunal intermesenteric defect with a herniated common channel and volvulus of the anastomosis. Conversion to open reduction and complete closure with non-absorbable interrupted sutures was performed. Small bowel resection was avoided. The patient was discharged 10 days after the operation and a healthy boy was born 4 weeks later. PMID:25538214

  13. Development of significant disordered eating in an adolescent following gastric bypass surgery.

    Science.gov (United States)

    Sondike, Stephen B; Pisetsky, Emily M; Luzier, Jessica L

    2016-03-01

    The development of eating pathology is a concern following bariatric surgery, even in the absence of any pre-surgical psychopathology. No consistent risk factors have emerged in the literature to identify those at greatest risk. However, post-surgical guidelines encourage eating behaviors that would be considered disordered in other contexts. We present a case of an adolescent developing bulimia nervosa following gastric bypass surgery and the escalation of her symptoms from diligently following recommended food behaviors to a full-syndrome clinical eating disorder. We discuss the differences between appropriate post-surgical eating behaviors and disordered eating behaviors. We provide recommendations for clinicians to screen for eating pathology and referrals to an interprofessional treatment team to address eating disordered behaviors and cognitions. PMID:26449853

  14. The predictive value of psychological assessment of candidates for gastric bypass: A medical chart review

    Directory of Open Access Journals (Sweden)

    Nathalie Aubert

    2010-06-01

    Full Text Available Background and Objectives: Guidelines for bariatric surgery demand a psychological evaluation of applicants. The aim of this study was to evaluate if the presence of "psychological risk factors" predicts postoperative weight loss after gastric bypass. Methods: Medical records of obese women who underwent bariatric surgery between 2000 and 2004 were reviewed. Psychological assessment consisted of a one-hour semi-structured interview, summarized in a written report. Anthropometric assessment at baseline and 6,12,18 and 24 months after surgery included body weight, height and body mass index. Results: The mean BMI of included patients (N = 92 was 46.2 + 6,3 kg/m² (range 38.4 - 69.7. Based on the psychological assessment, 27% (N = 25 of the patients were classified as having "psychological risk factors" and 28% (N = 26 were diagnosed with a psychiatric diagnosis, most often major depression. Two years after gastric bypass, 16% of patients with "psychological risk factors" achieved an excellent result (%EWL > 75 versus 39% of those without (p < 0.05. About 1 out of 4 patients was in postoperative psychiatric treatment, but only half of them were identified as having "psychological risk factors" at baseline. Weight loss of patients initiating a psychiatric treatment only after surgery was less than of patients who continued psychiatric treatment already initiated before surgery (55.7 + 14.8 versus 66.5 + 14.2 %EWL. Conclusions: A single semi-structured psychological interview may identify patients who are at risk for diminished postoperative weight loss; however, psychological assessment did not identify those patients who were in need of a psychiatric postoperative treatment.

  15. Risk of Post-Gastric Bypass Surgery Hypoglycemia in Nondiabetic Individuals: A Single Center Experience

    Science.gov (United States)

    Lee, Clare J.; Craig Wood, G.; Lazo, Mariana; Brown, Todd T.; Clark, Jeanne M.; Still, Christopher; Benotti, Peter

    2016-01-01

    Objective The epidemiology of post-gastric bypass surgery hypoglycemia (PGBH) is incompletely understood. This study aimed to evaluate the risk of PGBH among nondiabetic patients and associated factors. Methods A cohort study of nondiabetic patients who underwent Roux-en-Y gastric bypass (RYGB) was conducted. PGBH was defined by any postoperative record of glucose hypoglycemia, or any medication use for treatment of PGBH. Kaplan-Meier analysis was used to describe PGBH occurrence, log-rank tests, and Cox regression to examine associated factors. Results Of the 1,206 eligible patients, 86% were female with mean age of 43.7 years, mean preoperative BMI of 48.7 kg/m2, and a mean follow-up of 4.8 years. The cumulative incidence of hypoglycemia at 1 and 5 years post-RYGB was 2.7% and 13.3%, respectively. Incidence of PGBH was identified in 158 patients and was associated with lower preoperative BMI (P = 0.048), lower preoperative HbA1c (P = 0.012), and higher 6-month percent of excess body weight loss (%EWL) (P = 0.001). A lower preoperative HbA1c (HR = 1.73, P = 0.0034) and higher 6-month %EWL (HR = 1.96, P = 0.0074) remained independently correlated with increased risk for PGBH in multi-regression analysis. Conclusions The 5-year incidence of PGBH among nondiabetic individuals was 13.3% and was associated with a lower preoperative HbA1c and greater weight loss at 6 months following surgery. PMID:27225597

  16. Resveratrol: Anti-Obesity Mechanisms of Action

    OpenAIRE

    Leixuri Aguirre; Alfredo Fernández-Quintela; Noemí Arias; Maria P. Portillo

    2014-01-01

    Resveratrol is a non-flavonoid polyphenol which belongs to the stilbenes group and is produced naturally in several plants in response to injury or fungal attack. Resveratrol has been recently reported as preventing obesity. The present review aims to compile the evidence concerning the potential mechanisms of action which underlie the anti-obesity effects of resveratrol, obtained either in cultured cells lines and animal models. Published studies demonstrate that resveratrol has an anti-adip...

  17. Tamoxifen malabsorption after Roux-en-Y gastric bypass surgery: case series and review of the literature.

    Science.gov (United States)

    Wills, Shannon M; Zekman, Richard; Bestul, Daniel; Kuwajerwala, Nafisa; Decker, David

    2010-02-01

    Roux-en-Y gastric bypass is a gastric reduction duodenal switch with a combination of restrictive and malabsorptive procedures. It is the most common gastric bypass procedure performed in the United States. Malabsorption causing nutritional deficiencies does occur, yet a PubMed literature search (1955-2009) returned no reports of malabsorption of anticancer agents after gastric bypass. To our knowledge, this is the first report of three cases of malabsorption of the anticancer agent tamoxifen after this procedure. The first patient was a 58-year-old woman who underwent Roux-en-Y bypass for morbid obesity. Two years later, she developed estrogen receptor-positive ductal carcinoma in situ of the breast, underwent lumpectomy and irradiation, and tamoxifen was started. Two years after that, she presented with concerns of potential malabsorption of the drug. Her plasma tamoxifen level was 28 ng/ml, which was below the lower limit of the therapeutic range (77-274 ng/ml for 10-30-mg/day regimens). The second patient was a 51-year-old woman who sought medical advice on risk reduction for breast cancer after receiving a diagnosis of atypical ductal hyperplasia of the breast. She also had a history of morbid obesity and underwent Roux-en-Y bypass. Tamoxifen was started to reduce her risk of breast cancer; her plasma tamoxifen level was subtherapeutic at 14 ng/ml. The third patient was a 53-year-old woman with estrogen receptor-positive breast cancer who underwent lumpectomy and was prescribed anastrozole, an aromatase inhibitor. She also underwent Roux-en-Y bypass for morbid obesity. As she experienced adverse effects while receiving anastrozole, the drug was discontinued, and tamoxifen 20 mg/day was started. Her tamoxifen plasma level was 52 ng/ml. Therefore, her tamoxifen dosage was increased to 20 mg twice/day. Six weeks later, her tamoxifen level was 120 ng/ml (therapeutic range 95-520 ng/ml for the increased dosage). These three cases suggest that steady-state serum

  18. Laparoscopic gastric pouch and remnant resection: a novel approach to refractory anastomotic ulcers after Roux-en-Y Gastric Bypass: Case report

    Directory of Open Access Journals (Sweden)

    Steinemann Daniel C

    2011-12-01

    Full Text Available Abstract Background Anastomotic or marginal ulcers occur in 0.6 to 16% of patients after laparoscopic Roux-en-Y-Gastric Bypass. Initial therapy aims at eliminating known risk factors including smoking, Helicobacter pylori infection, use of non-steroidal anti-inflammatory drugs and inhibition of gastric acid secretion. While this approach is successful in 68 to 88% of the cases, up to one third of patients need a subsequent surgical revision. However, marginal ulcers still recur in up to 10% of cases after revisional surgery, thus constituting a serious challenge for bariatric surgeons. Case presentation We herein report a case of an insidious marginal ulcer refractory to both medical therapy with high-dosed proton pump inhibitors and sucralfate as well as surgical therapy consisting of the lengthening of a short alimentary limb and later resection of the gastroenterostomy and construction of a new tension-free anastomosis. Only after gastrectomy by laparoscopic en-bloc resection of the gastrojejunostomy, the gastric pouch and resection of the gastric remnant with reconstruction by esophagojejunostomy the patient remained free of symptoms. Conclusion By laparoscopic resection of the entire gastric pouch and the gastric remnant the risk to leave a suboptimally vascularised or even ischemic pouch in situ was avoided. The esophagojejunostomy was then created in healthy, good vascularised tissue. In our case this novel approach was effective in the management of a refractory anastomotic ulcer and might represent a rescue option when simple revision of the gastrojejunostomy fails.

  19. Fetal Growth in Pregnancies Conceived after Gastric Bypass Surgery in Relation to Surgery-to-Conception Interval

    DEFF Research Database (Denmark)

    Nørgaard, Lone Nikoline; Gjerris, Anne Cathrine Roslev; Kirkegaard, Ida;

    2014-01-01

    OBJECTIVE: To describe early and late fetal growth in pregnancies conceived after gastric bypass surgery in relation to time from surgery to conception of pregnancy. METHODS: National cohort study on 387 Danish women, who had laparoscopic or open gastric bypass surgery prior to a singleton...... pregnancy in which first trimester screening was performed between January 2008 and June 2011. Data were derived from national registers (Danish National Registry of Patients and Danish National Birth Registry, Pregnancy Complications and Abortion-clinical quality database (PreCAb) and the Danish Fetal...... Medicine Database). Main outcome measures were early and late fetal growth in relation to time from bariatric surgery to conception of the pregnancy. Early fetal growth was expressed as "Fetal Growth Index": the ratio between the estimated number of days from first trimester ultrasound to second trimester...

  20. Presurgical Weight Is Associated with Pain, Functional Impairment, and Anxiety among Gastric Bypass Surgery Patients

    Directory of Open Access Journals (Sweden)

    Sharlene Wedin

    2012-01-01

    Full Text Available Chronic pain and obesity are significant public health concerns in the United States associated with significant levels of health-care expenses and lost productivity. Previous research suggests that obesity is a risk factor for chronic pain, mainly due to excessive weight placed on the joints. However, the obesity-pain relationship appears to be complex and reciprocal. Little work to date has focused on the relationship between weight and pain among patients undergoing gastric bypass surgery for weight loss. Patients scheduled to undergo bariatric surgery for weight loss at a large southeastern academic medical center ( completed the Brief Pain Inventory (BPI, the Center for Epidemiological Studies 10-item Depression scale (CESD-10, and the Beck Anxiety Inventory (BAI. Higher presurgical weight was associated with higher pain-on-average ratings, higher functional impairment due to pain across the domains of physical activity, mood, walking ability, relationships, and enjoyment of life. Higher presurgical weight was associated with higher BAI scores, but weight was not related to depression. Findings suggest that bariatric surgery candidates report a moderate amount of pain prior to surgery and that presurgical weight is associated with higher pain, increased functional impairment due to pain, and increased anxiety. Anxiety was found to mediate the relationship between increased weight and pain.

  1. Intestinal adaptations in chronic kidney disease and the influence of gastric bypass surgery.

    Science.gov (United States)

    Hatch, Marguerite

    2014-09-01

    Studies have shown that compensatory adaptations in gastrointestinal oxalate transport can impact the amount of oxalate excreted by the kidney. Hyperoxaluria is a major risk factor in the formation of kidney stones, and oxalate is derived from both the diet and the liver metabolism of glyoxylate. Although the intestine generally absorbs oxalate from dietary sources and can contribute as much as 50% of urinary oxalate, enteric oxalate elimination plays a significant role when renal function is compromised. While the mechanistic basis for these changes in the direction of intestinal oxalate movements in chronic renal failure involves an upregulation of angiotensin II receptors in the large intestine, enteric secretion/excretion of oxalate can also occur by mechanisms that are independent of angiotensin II. Most notably, the commensal bacterium Oxalobacter sp. interacts with the host enterocyte and promotes the movement of oxalate from the blood into the lumen, resulting in the beneficial effect of significantly lowering urinary oxalate excretion. Changes in the passive permeability of the intestine, such as in steatorrhoea and following gastric bypass, also promote oxalate absorption and hyperoxaluria. In summary, this report highlights the two-way physiological signalling between the gut and the kidney, which may help to alleviate the consequences of certain kidney diseases. PMID:24951497

  2. Cortical and trabecular deterioration in mouse models of Roux-en-Y gastric bypass.

    Science.gov (United States)

    Yu, Elaine W; Carmody, Jill S; Brooks, Daniel J; LaJoie, Scott; Kaplan, Lee M; Bouxsein, Mary L

    2016-04-01

    Roux-en-Y gastric bypass (RYGB) is a profoundly effective treatment for severe obesity, but results in significant bone loss in patients. Developing a murine model that recapitulates this skeletal phenotype will provide a robust tool with which to study the physiologic mechanisms of this bone loss. We studied adult male C57BL/6J mice who underwent either RYGB or sham operation. Twelve weeks after surgery, we characterized biochemical bone markers (parathyroid hormone, PTH; C-telopeptide, CTX; and type 1 procollagen, P1NP) and bone microarchitectural parameters as measured by microcomputed tomography. RYGB-treated mice had significant trabecular and cortical bone deficits compared with sham-operated controls. Although adjustment for final body weight eliminated observed cortical differences, the trabecular bone volume fraction remained significantly lower in RYGB mice even after weight adjustment. PTH levels were similar between groups, but RYGB mice had significantly higher indices of bone turnover than sham controls. These data demonstrate that murine models of RYGB recapitulate patterns of bone loss and turnover that have been observed in human clinical studies. Future studies that exploit this murine model will help delineate the alterations in bone metabolism and mechanisms of bone loss after RYGB. PMID:26806052

  3. Hepatic phosphoenolpyruvate carboxykinase expression after gastric bypass surgery in rats with type 2 diabetes mellitus.

    Science.gov (United States)

    Wu, J; Hou, S S; Wang, W; Yin, M; Cheng, N; Ge, L L; Yin, J J; Xu, J

    2015-01-01

    The objective of this study was to investigate the mRNA expression of hepatic phosphoenolpyruvate carboxykinase (PEPCK) after gastric bypass surgery (GBS) in rats with type 2 diabetic mellitus (T2DM). Thirty-six male Goto-Kakizaki rats, aged 12 weeks, were randomly divided into the GBS, sham operation with diet restriction (SO), and sham operation alone (control) groups (N = 12 per group). Liver specimens from all rats were obtained during the operation and 8 weeks after operation. Blood lipid levels were measured before and 8 weeks after operation. Fasting blood glucose (FBG), food intake, and body weight were recorded at weekly time points after operation. The blood glucose area under the curve (AUC) was calculated, and insulin sensitivity indices (ISI) were assessed. The expression PEPCK mRNA and protein were measured by real-time polymerase chain reaction and western blot. Compared with those of the SO and control groups, the blood lipid levels and the FBG in the GBS group was significantly decreased (P rats while improving glucose tolerance and hyperglycemia, and the mechanism appears to be associated with a decrease of hepatic PEPCK mRNA and protein expression. PMID:26681041

  4. Sleeve Gastrectomy and Roux-en-Y Gastric Bypass Alter the Gut-Brain Communication

    Directory of Open Access Journals (Sweden)

    L. A. Ballsmider

    2015-01-01

    Full Text Available This study investigated the anatomical integrity of vagal innervation of the gastrointestinal tract following vertical sleeve gastrectomy (VSG and Roux-en-Y gastric bypass (RYGB operations. The retrograde tracer fast blue (FB was injected into the stomach to label vagal neurons originating from nodose ganglion (NG and dorsal motor nucleus of the vagus (DMV. Microglia activation was determined by quantifying changes in the fluorescent staining of hindbrain sections against an ionizing calcium adapter binding molecule 1 (Iba1. Reorganization of vagal afferents in the hindbrain was studied by fluorescent staining against isolectin 4 (IB4. The density of Iba1- and IB4-immunoreactivity was analyzed using Nikon Elements software. There was no difference in the number of FB-labeled neurons located in NG and DMV between VSG and VSG-sham rats. RYGB, but not RYGB-sham rats, showed a dramatic reduction in number of FB-labeled neurons located in the NG and DMV. VSG increased, while the RYGB operation decreased, the density of vagal afferents in the nucleus tractus solitarius (NTS. The RYGB operation, but not the VSG procedure, significantly activated microglia in the NTS and DMV. Results of this study show that the RYGB, but not the VSG procedure, triggers microglia activation in vagal structures and remodels gut-brain communication.

  5. Prospective evaluation of laparoscopic Roux en Y gastric bypass in patients with clinically severe obesity

    Institute of Scientific and Technical Information of China (English)

    Konstantinos Vagenas; Spyros Panagiotopoulos; Ioannis Kehagias; Stavros Nikolaos Karamanakos; Nancy Mead; Fotis Kalfarentzos

    2008-01-01

    AIM: To evaluate and present our experience with laparoscopic Roux en Y gastric bypass (RYGB) in a selected patient population.METHODS: A cohort of 130 patients with a body mass index (BMI) between 35 and 50 kg/m2 were evaluated in relation to postoperative morbidity, weight loss and resolution of co-morbidities for a period of 4 years following laparoscopic RYGB.RESULTS: Early morbidity was 10.0%, including 1 patient with peritonitis who was admitted to Intensive Care Unit (ICU) and 1 conversion to open RYGB early in the series. There was no early or late mortality. Maximum weight loss was achieved at 12 mo postoperatively, with mean BMI 30 kg/m2, mean percentage of excess weight loss (EWL%) 66.4% and mean percentage of initial weight loss (IWL%) 34.3% throughout the follow-up period. The majority of preexisting comorbidities were resolved after weight loss and no major metabolic disturbances or nutritional deficiencies were observed.CONCLUSION: Laparoscopic RYGB appears to be a safe and effective procedure for patients with BMI 35-50 kg/m2 with results that are comparable to previously published data mostly from the USA but from Europe as well.

  6. Gastric Bypass Surgery Reverses Diabetic Phenotypes in Bdnf-Deficient Mice.

    Science.gov (United States)

    Jiang, Shujun; Wang, Qinghua; Huang, Zan; Song, Anying; Peng, Yu; Hou, Siyuan; Guo, Shiying; Zhu, Weiyun; Yan, Sheng; Lin, Zhaoyu; Gao, Xiang

    2016-08-01

    Duodenum-jejunum gastric bypass (DJB) has been used to treat morbid diabetic patients. However, neither the suitability among patients nor the mechanisms of this surgical treatment is clear. Previously, we reported a new mouse strain named Timo as type 2 diabetes model caused by brain-derived neurotrophic factor (Bdnf) deficiency. In this study, we found that DJB on Timo mice reversed their metabolic abnormalities without altering the expression of Bdnf. Glucose tolerance and insulin sensitivity were improved greatly, along with reduction of fat accumulation in liver and white adipose tissue. The gut flora population was altered by DJB with increased proportion of Firmicutes and decreased Actinobacteria and Proteobacteria in the ileum after surgery. Systemic inflammation in Timo mice was greatly suppressed with less macrophage infiltration and lower tumor necrosis factor-α levels in liver and white adipose tissue after surgery. Interestingly, the alteration of gut microflora abundance and improved metabolism preceded the inflammation alleviation after DJB surgery. These results suggested that DJB can reverse Bdnf deficiency-associated metabolic abnormality. In addition, the reduced inflammation may not be the initial cause for the DJB-associated metabolic and microbiota alterations. The increased BDNF protein levels in hypothalamus and hippocampus may result from microbiota change after DJB surgery. PMID:27418549

  7. The mechanistic basis of hyperoxaluria following gastric bypass in obese rats.

    Science.gov (United States)

    Hatch, Marguerite; Canales, Benjamin K

    2016-06-01

    Roux-en-Y gastric bypass (RYGB) surgery is a popular and extremely effective procedure for sustained weight loss in the morbidly obese. However, hyperoxaluria and oxalate kidney stones frequently develop after RYGB and steatorrhea has been speculated to play a role. We examined the effects of RYGB and the role of dietary fat in an obese rat model by measuring fecal fat content and transmural oxalate fluxes across the distal colon compared to sham-operated controls (SHAM). Direct measurements of fecal fat content confirmed that RYGB on a 10 % fat diet excreted 40-fold more fecal fat than SHAM and, on a 40 % fat diet, RYGB excreted sevenfold more fecal fat than SHAM fed similarly. Results from the transport studies revealed a clear effect of high dietary fat (40 %) on colonic oxalate permeability and tissue conductance (G T) with comparable oxalate fluxes in RYGB and in SHAM. Administering a diet containing 10 % fat to both groups distinguished differences between RYGB and SHAM, revealing a 40 % increase in G T in RYGB and a reversal in the direction of net oxalate flux from absorption in SHAM to secretion in RYGB. These changes in colonic oxalate permeability were associated with a fourfold increase in urinary oxalate excretion in RYGB compared to SHAM. Therefore, oxalate solubility and permeability in the RYGB model are promoted by steatorrhea and result in enhanced passive oxalate absorption and hyperoxaluria. To our knowledge, these are the first measurements of intestinal oxalate transport in rats with RYGB. PMID:26584912

  8. Changes in vertebral bone marrow fat and bone mass after gastric bypass surgery: A pilot study.

    Science.gov (United States)

    Schafer, A L; Li, X; Schwartz, A V; Tufts, L S; Wheeler, A L; Grunfeld, C; Stewart, L; Rogers, S J; Carter, J T; Posselt, A M; Black, D M; Shoback, D M

    2015-05-01

    Bone marrow fat may serve a metabolic role distinct from other fat depots, and it may be altered by metabolic conditions including diabetes. Caloric restriction paradoxically increases marrow fat in mice, and women with anorexia nervosa have high marrow fat. The longitudinal effect of weight loss on marrow fat in humans is unknown. We hypothesized that marrow fat increases after Roux-en-Y gastric bypass (RYGB) surgery, as total body fat decreases. In a pilot study of 11 morbidly obese women (6 diabetic, 5 nondiabetic), we measured vertebral marrow fat content (percentage fat fraction) before and 6 months after RYGB using magnetic resonance spectroscopy. Total body fat mass declined in all participants (mean ± SD decline 19.1 ± 6.1 kg or 36.5% ± 10.9%, pEffects of RYGB on marrow fat differed by diabetes status (adjusted p=0.04). There was little mean change in marrow fat in nondiabetic women (mean +0.9%, 95% CI -10.0 to +11.7%, p=0.84). In contrast, marrow fat decreased in diabetic women (-7.5%, 95% CI -15.2 to +0.1%, p=0.05). Changes in total body fat mass and marrow fat were inversely correlated among nondiabetic (r=-0.96, p=0.01) but not diabetic (r=0.52, p=0.29) participants. In conclusion, among those without diabetes, marrow fat is maintained on average after RYGB, despite dramatic declines in overall fat mass. Among those with diabetes, RYGB may reduce marrow fat. Thus, future studies of marrow fat should take diabetes status into account. Marrow fat may have unique metabolic behavior compared with other fat depots. PMID:25603463

  9. Leptin Is Required for Glucose Homeostasis after Roux-en-Y Gastric Bypass in Mice.

    Directory of Open Access Journals (Sweden)

    Mohamad Mokadem

    Full Text Available Leptin, the protein product of the ob gene, increases energy expenditure and reduces food intake, thereby promoting weight reduction. Leptin also regulates glucose homeostasis and hepatic insulin sensitivity via hypothalamic proopiomelanocortin neurons in mice. Roux-en-Y gastric bypass (RYGB induces weight loss that is substantial and sustained despite reducing plasma leptin levels. In addition, patients who fail to undergo diabetes remission after RYGB are hypoletinemic compared to those who do and to lean controls. We have previously demonstrated that the beneficial effects of RYGB in mice require the melanocortin-4 receptor, a downstream effector of leptin action. Based on these observations, we hypothesized that leptin is required for sustained weight reduction and improved glucose homeostasis observed after RYGB.To investigate this hypothesis, we performed RYGB or sham operations on leptin-deficient ob/ob mice maintained on regular chow. To investigate whether leptin is involved in post-RYGB weight maintenance, we challenged post-surgical mice with high fat diet.RYGB reduced total body weight, fat and lean mass and caused reduction in calorie intake in ob/ob mice. However, it failed to improve glucose tolerance, glucose-stimulated plasma insulin, insulin tolerance, and fasting plasma insulin. High fat diet eliminated the reduction in calorie intake observed after RYGB in ob/ob mice and promoted weight regain, although not to the same extent as in sham-operated mice. We conclude that leptin is required for the effects of RYGB on glucose homeostasis but not body weight or composition in mice. Our data also suggest that leptin may play a role in post-RYGB weight maintenance.

  10. Bone Structural Changes and Estimated Strength After Gastric Bypass Surgery Evaluated by HR-pQCT.

    Science.gov (United States)

    Frederiksen, Katrine Diemer; Hanson, Stine; Hansen, Stinus; Brixen, Kim; Gram, Jeppe; Jørgensen, Niklas Rye; Støving, René Klinkby

    2016-03-01

    Roux-en-Y gastric bypass surgery (RYGB) is an effective treatment of morbid obesity, with positive effects on obesity-related complications. The treatment is associated with bone loss, which in turn might increase fracture risk. The aim of this study was to evaluate changes in bone mineral density (BMD) and bone architecture assessed using dual-energy X-ray absorptiometry (DXA) and high-resolution peripheral quantitative computed tomography (HR-pQCT), 6 and 12 months after RYGB, and correlate them to changes in selected biochemical markers. A prospective cohort study included 25 morbidly obese patients (10 males, 15 females). Patients were examined with DXA of the hip and spine, HR-pQCT of radius and tibia, and blood sampling before and 6 and 12 months after RYGB. Patients lost in average 33.5 ± 12.1 kg (25.8 ± 8.5 %) in 12 months. In tibia, we found significant loss of total, cortical and trabecular volumetric BMD after 12 months (all p < 0.001). Microarchitectural changes involved lower trabecular number, increased trabecular separation, and network inhomogeneity along with thinning of the cortex. Estimated bone failure load was decreased after 12 months (p = 0.005). We found only minor changes in radius. Results demonstrate significant alterations of bone microarchitecture suggesting an accelerated endosteal resorption along with disintegration of the trabecular structure which resulted in a loss of estimated bone strength in tibia. Such changes may underlie the recently reported increased risk of fracture in bariatric patients after surgery. We only observed bone structural changes in the weight-bearing bone, which indicates that mechanical un-loading is the primary mediator. PMID:26661530

  11. Ischemic colitis after mesotherapy combined with anti-obesity medications.

    Science.gov (United States)

    Kim, Jong Bin; Moon, Won; Park, Seun Ja; Park, Moo In; Kim, Kyu-Jong; Lee, Jae Nam; Kang, Seong Joo; Jang, Lee La; Chang, Hee Kyung

    2010-03-28

    Mesotherapy and anti-obesity medications are gradually gaining worldwide popularity for purposes of body contouring and weight loss. Their adverse effects are various, but there is a tendency to disregard them. Ischemic colitis is one of the most common diseases associated with non-obstructive blood vessel disorders. However, there have been no case reports about the adverse effects resulting from mesotherapy only or in combination with anti-obesity medications. We report on an interesting case of ischemic colitis after mesotherapy combined with anti-obesity medications in a 39-year-old female who had no risk factors. PMID:20333798

  12. Utility of barium studies for patients with recurrent weight gain after Roux-en-Y gastric bypass

    International Nuclear Information System (INIS)

    Aim: To determine the utility of barium studies for detecting abnormalities responsible for recurrent weight gain after gastric bypass surgery. Methods: A computerized search identified 42 patients who had undergone barium studies for recurrent weight gain after gastric bypass and 42 controls. The images were reviewed to determine the frequency of staple-line breakdown and measure the length/width of the pouch and gastrojejunal anastomosis. A large pouch exceeded 6 cm in length or 5 cm in width and a wide anastomosis exceeded 2 cm. Records were reviewed for the amount of recurrent weight gain and subsequent weight loss after additional treatment. Results: Staple-line breakdown was present in 6/42 patients (14%) with recurrent weight gain. When measurements were obtained, 13/35 patients (37%) with recurrent weight gain had a large pouch, three (9%) had a wide anastomosis, and four (11%) had both, whereas 22/42 controls (52%) had a large pouch, one (2%) had a wide anastomosis, and two (5%) had both. Ten patients (24%) with recurrent weight gain underwent staple-line repair (n = 3) or pouch/anastomosis revision (n = 7). These 10 patients had a mean weight loss of 38.1 lbs versus a mean loss of 8.6 lbs in 19 patients managed medically. Conclusion: Only 14% of patients with recurrent weight gain after gastric bypass had staple-line breakdown, whereas 57% had a large pouch, wide anastomosis, or both. Not all patients with abnormal anatomy had recurrent weight gain, but those who did were more likely to benefit from surgical intervention than from medical management. - Highlights: • Only 14% of patients with recurrent weight gain after gastric bypass had GGFs. • The majority of patients with recurrent weight gain had a large pouch/wide GJA. • Many patients without recurrent weight gain also had a large pouch/wide GJA. • Those with weight gain and a large pouch/wide GJA are likely to benefit from surgery

  13. Meal-Induced Hormone Responses in a Rat Model of Roux-en-Y Gastric Bypass Surgery

    OpenAIRE

    Shin, Andrew C.; Zheng, Huiyuan; Townsend, R. Leigh; Sigalet, David L.; Berthoud, Hans-Rudolf

    2010-01-01

    Roux-en-Y gastric bypass (RYGB) surgery is the most effective treatment for morbid obesity and remission of associated type 2 diabetes, but the mechanisms involved are poorly understood. The aim of the present study was to develop and validate a rat model for RYGB surgery that allows repeated measurement of meal-induced changes in gut and pancreatic hormones via chronic venous catheters. Male Sprague Dawley rats made obese on a palatable high-fat diet were subjected to RYGB or sham surgery an...

  14. Evaluation of feasibility, efficiency and safety of a pure NOTES gastrojejunal bypass with gastric outlet obstruction, in an in vivo porcine model

    OpenAIRE

    Gonzalez, J.-M.; Bonin, E. A.; Vanbiervliet, G; Garnier, E.; Berdah, S.; K. Matthes; Barthet, M

    2013-01-01

    Introduction: Natural orifice transluminal endoscopic surgery (NOTES) gastrojejunal anastomosis (GJA) is a less invasive surgery for bariatric procedures and gastric outlet obstruction. The aim of this study was to evaluate the feasibility, efficacy, and safety of a pure NOTES gastrojejunal bypass using an in vivo porcine model. Material and methods: A prospective study was performed on nine swine. A double-channel scope was used. The intervention steps were: (i) gastric incision; (ii) perito...

  15. Ischemic colitis after mesotherapy combined with anti-obesity medications

    OpenAIRE

    Kim, Jong Bin; Moon, Won; Park, Seun Ja; Park, Moo In; Kim, Kyu-Jong; Lee, Jae Nam; Kang, Seong Joo; Jang, Lee La; Chang, Hee Kyung

    2010-01-01

    Mesotherapy and anti-obesity medications are gradually gaining worldwide popularity for purposes of body contouring and weight loss. Their adverse effects are various, but there is a tendency to disregard them. Ischemic colitis is one of the most common diseases associated with non-obstructive blood vessel disorders. However, there have been no case reports about the adverse effects resulting from mesotherapy only or in combination with anti-obesity medications. We report on an interesting ca...

  16. Cirugía bariátrica laparoscópica: bypass gástrico proximal Laparoscopic bariatric surgery: proximal gastric bypass

    Directory of Open Access Journals (Sweden)

    F. Rotellar

    2005-01-01

    Full Text Available El espectacular aumento en la prevalencia de la obesidad en nuestra sociedad y las importantes complicaciones y comorbilidades que origina ha despertado el interés de científicos y público en esta patología. El tratamiento quirúrgico es en la actualidad el único tratamiento eficaz y duradero para la obesidad mórbida y en muchos casos, mejora sensiblemente e incluso cura definitivamente complicaciones asociadas como es el caso de la diabetes o la hipertensión. De entre las diversas técnicas de cirugía bariátrica, parece imponerse definitvamente el by-pass gástrico (BPG, al ofrecer un excelente balance entre pérdida de peso (70% del exceso y riesgo quirúrgico y calidad de vida posterior. La posiblidad de realizar esta técnica mediante un abordaje laparoscópico ha mejorado su aceptación por parte de médicos y pacientes al tiempo que ha permitido disminuir morbimortalidad, estancia y costes. El BPG proximal se realiza en aquellos pacientes con un IMC The spectacular increase in the prevalence of obesity in our society and the significant complications and comorbidities that it gives rise to have stimulated the interest of scientists and public in this pathology. Surgical treatment is at present the only efficient and lasting treatment for morbid obesity and in many cases it appreciably improves, and even definitively cures, associated complications such as the case of diabetes or hypertension. Amongst the different techniques of bariatric surgery, the gastric bypass (GBP seems to be definitively establishing itself, since it offers an excellent balance between loss of weight (70% of the excess, surgical risk and subsequent quality of life. The possibility of carrying out this technique employing a laparoscopic approach has improved its acceptance by doctors and patients while it has made it possible to reduce morbidity and mortality, length of hospital stay and costs. Proximal GBP is carried on those patients with an BMI <60 Kg

  17. Effect of Roux-en-Y gastric bypass surgery on intestinal Akkermansia muciniphila

    Science.gov (United States)

    Yan, Ming; Song, Mao-Min; Bai, Ri-Xing; Cheng, Shi; Yan, Wen-Mao

    2016-01-01

    AIM: To investigated changes in intestinal Akkermansia muciniphila (A. muciniphila) and explored the mechanism underlying the therapeutic effects of Roux-en-Y gastric bypass (RYGB) surgery on type 2 diabetes in diabetic Goto-Kakizaki (GK) rats. METHODS: Male diabetic GK rats (n = 12) aged 8 wk were randomly assigned to the surgery group (GK-RYGB) or sham surgery group (GK-Sham) (n = 6 per group), and another 6 male Wistar rats aged 8 wk served as controls (WS-Sham). In the surgery group, RYGB surgery was conducted, and a sham operation was performed in both sham groups. Fasting blood glucose (FBG) levels before and after surgery, fasting levels of serum insulin and serum glucagon-like peptide-1 (GLP-1) and levels 30 min after intragastric injection of glucose, and the amount of A. muciniphila in the stool were determined. Insulin and GLP-1 were measured by enzyme-linked immunosorbent assay, and A. muciniphila were detected by fluorescence-based quantitative polymerase chain reaction. RESULTS: The FBG was improved, and serum GLP-1 and insulin increased significantly (P < 0.05) in the GK-RYGB group after surgery compared to levels before surgery and to levels in the GK-Sham group. Before surgery, the amounts of A. muciniphila in the GK-RYGB and GK-Sham groups were significantly lower than in the WS-Sham group (P < 0.05). After surgery, the amount of A. muciniphila in the GK-RYGB group increased markedly compared to that before surgery and to that in the GK-Sham and WS-Sham groups (P < 0.05). In addition, the A. muciniphila amount was positively related to GLP-1 (r = 0.86, P < 0.05). CONCLUSION: Our results demonstrated RYGB surgery may increase GLP-1 secretion, elevate serum insulin after intragastric injection of glucose, and improve insulin resistance in diabetic GK rats, thereby contributing to a significant reduction in blood glucose. The increased amount of A. muciniphila after RYGB surgery may be related to elevated GLP-1 secretion.

  18. Resveratrol: Anti-Obesity Mechanisms of Action

    Directory of Open Access Journals (Sweden)

    Leixuri Aguirre

    2014-11-01

    Full Text Available Resveratrol is a non-flavonoid polyphenol which belongs to the stilbenes group and is produced naturally in several plants in response to injury or fungal attack. Resveratrol has been recently reported as preventing obesity. The present review aims to compile the evidence concerning the potential mechanisms of action which underlie the anti-obesity effects of resveratrol, obtained either in cultured cells lines and animal models. Published studies demonstrate that resveratrol has an anti-adipogenic effect. A good consensus concerning the involvement of a down-regulation of C/EBPα and PPARγ in this effect has been reached. Also, in vitro studies have demonstrated that resveratrol can increase apoptosis in mature adipocytes. Furthermore, different metabolic pathways involved in triacylglycerol metabolism in white adipose tissue have been shown to be targets for resveratrol. Both the inhibition of de novo lipogenesis and adipose tissue fatty acid uptake mediated by lipoprotein lipase play a role in explaining the reduction in body fat which resveratrol induces. As far as lipolysis is concerned, although this compound per se seems to be unable to induce lipolysis, it increases lipid mobilization stimulated by β-adrenergic agents. The increase in brown adipose tissue thermogenesis, and consequently the associated energy dissipation, can contribute to explaining the body-fat lowering effect of resveratrol. In addition to its effects on adipose tissue, resveratrol can also acts on other organs and tissues. Thus, it increases mitochondriogenesis and consequently fatty acid oxidation in skeletal muscle and liver. This effect can also contribute to the body-fat lowering effect of this molecule.

  19. Changes in Gastrointestinal Hormone Responses, Insulin Sensitivity, and Beta-Cell Function Within 2 Weeks After Gastric Bypass in Non-diabetic Subjects

    DEFF Research Database (Denmark)

    Jacobsen, S H; Olesen, S C; Dirksen, C;

    2012-01-01

    Roux-en-Y gastric bypass (RYGB) surgery causes profound changes in secretion of gastrointestinal hormones and glucose metabolism. We present a detailed analysis of the early hormone changes after RYGB in response to three different oral test meals designed to provide this information without caus...... causing side effects (such as dumping)....

  20. The Effect of Roux-en-Y Gastric Bypass Surgery in Morbidly Obese Patients on Pharmacokinetics of (Acetyl)Salicylic Acid and Omeprazole : the ERY-PAO Study

    NARCIS (Netherlands)

    Mitrov-Winkelmolen, Lieke; van Buul-Gast, Marie-Christine W; Swank, Dingeman J; Overdiek, Hans W P M; van Schaik, Ron H N; Touw, Daan J

    2016-01-01

    BACKGROUND: Data on the absorption of orally administered drugs following Roux-en-Y gastric bypass (RYGB) surgery in obese patients are limited and inconclusive. As it is difficult to predict changes in absorption, studies on frequently used drugs in this population are necessary. Acetylsalicylic ac

  1. Changes in problematic and disordered eating after gastric bypass, adjustable gastric banding and vertical sleeve gastrectomy: a systematic review of pre-post studies.

    Science.gov (United States)

    Opozda, M; Chur-Hansen, A; Wittert, G

    2016-08-01

    Despite differences in their mechanisms and outcomes, little is known about whether postsurgical changes in eating behaviours also differ by bariatric procedure. Following a systematic search, 23 studies on changes in binge eating disorder (BED) and related behaviours, bulimia nervosa and related behaviours, night eating syndrome, grazing and emotional eating after Roux-en-Y gastric bypass (RYGB), adjustable gastric banding (AGB) and vertical sleeve gastrectomy (VSG) were reviewed. Significant methodological problems and a dearth of literature regarding many behaviours and VSG were seen. Regarding BED and related behaviours, although later re-increases were noted, short to medium-term reductions after RYGB were common, and reported changes after AGB were inconsistent. Short to medium-term reductions in emotional eating, and from a few studies, short to long-term reductions in bulimic symptoms, were reported after RYGB. Reoccurrences and new occurrences of problem and disordered eating, especially BED and binge episodes, were apparent after RYGB and AGB. Further conclusions and comparisons could not be made because of limited or low-quality evidence. Long-term comparison studies of changes to problematic and disordered eating in RYGB, AGB and VSG patients are needed. It is currently unclear whether any bariatric procedure leads to long-term improvement of any problematic or disordered eating behaviours. PMID:27296934

  2. Acute small bowel obstruction due to a large intraluminal blood clot after laparoscopic Roux-en-Y gastric bypass.

    Science.gov (United States)

    Green, Jessica; Ikuine, Tomoko; Hacker, Shoshana; Urrego, Hernan; Tuggle, Karleena

    2016-01-01

    Small bowel obstructions (SBOs) are a known perioperative complication of laparoscopic Roux-en-Y gastric bypass and common etiologies include internal hernia, port site hernia, jejunojejunostomy stricture, ileus and adhesions. Less commonly, SBO can be caused by superior mesenteric artery syndrome, intussusception and intraluminal blood clot. We present a case of SBO caused by intraluminal blood clot from jejunojejunostomy staple line bleeding in a patient with a normal coagulation profile. Computed tomography was used to elucidate the cause of perioperative SBO, and diagnostic laparoscopy was used to both diagnose and treat the complication. In this case, the intraluminal clot was evacuated laparoscopically by enterotomy, thrombectomy and primary closure without anastomotic revision since there was no evidence of continued bleeding. Administration of enoxaparin and Toradol post-operatively may have exacerbated mild intraluminal bleeding occurring at the stapled jejunojejunal anastomosis. Prompt recognition and treatment of perioperative SBO can prevent catastrophic consequences related to bowel perforation. PMID:27554828

  3. Metabolite profiling identifies candidate markers reflecting the clinical adaptations associated with Roux-en-Y gastric bypass surgery.

    Directory of Open Access Journals (Sweden)

    David M Mutch

    Full Text Available BACKGROUND: Roux-en-Y gastric bypass (RYGB surgery is associated with weight loss, improved insulin sensitivity and glucose homeostasis, and a reduction in co-morbidities such as diabetes and coronary heart disease. To generate further insight into the numerous metabolic adaptations associated with RYGB surgery, we profiled serum metabolites before and after gastric bypass surgery and integrated metabolite changes with clinical data. METHODOLOGY AND PRINCIPAL FINDINGS: Serum metabolites were detected by gas and liquid chromatography-coupled mass spectrometry before, and 3 and 6 months after RYGB in morbidly obese female subjects (n = 14; BMI = 46.2+/-1.7. Subjects showed decreases in weight-related parameters and improvements in insulin sensitivity post surgery. The abundance of 48% (83 of 172 of the measured metabolites changed significantly within the first 3 months post RYGB (p<0.05, including sphingosines, unsaturated fatty acids, and branched chain amino acids. Dividing subjects into obese (n = 9 and obese/diabetic (n = 5 groups identified 8 metabolites that differed consistently at all time points and whose serum levels changed following RYGB: asparagine, lysophosphatidylcholine (C18:2, nervonic (C24:1 acid, p-Cresol sulfate, lactate, lycopene, glucose, and mannose. Changes in the aforementioned metabolites were integrated with clinical data for body mass index (BMI and estimates for insulin resistance (HOMA-IR. Of these, nervonic acid was significantly and negatively correlated with HOMA-IR (p = 0.001, R = -0.55. CONCLUSIONS: Global metabolite profiling in morbidly obese subjects after RYGB has provided new information regarding the considerable metabolic alterations associated with this surgical procedure. Integrating clinical measurements with metabolomics data is capable of identifying markers that reflect the metabolic adaptations following RYGB.

  4. Improvement of C peptide zero BMI 24-34 diabetic patients after tailored one anastomosis gastric bypass (BAGUA

    Directory of Open Access Journals (Sweden)

    M. Garcia-Caballero

    2013-01-01

    Full Text Available Background: Although bariatric surgery proved to be a very effective method in the treatment of patients in whose pancreas still produce insulin (type 2 diabetes, the accompanied metabolic syndrome and their diabetes complications, there is no information on the effect of this type of surgery in BMI24-34 patients when pancreas do not produce insulin at all (type 1, LADA and long term evolution type 2 diabetes among others. Patients and methods: We report preliminary data of a serie of 11 patients all with a C-peptide values below 0.0 ng/ml. They were followed for 6 to 60 months (mean 19 months after surgery. We studied the changes in glycemic control, evolution of the metabolic syndrome and diabetes complications after one anastomosis gastric bypass (BAGUA. Results: All values relative to glycemic control were improved HbA1c (from 8.9 ± 0.6 to 6.7 ± 0.2%, FPG (Fasting Plasma Glucose [from 222.36 ± 16.87 to 94 ± 5 (mg/dl] as well as the daily insulin requirement of rapid (from 40.6 ± 12.8 to 0 (U/d and long-lasting insulin (from 41.27 ± 7.3 U/day to 15.2 ± 3.3 U/day. It resolved 100% of the metabolic syndrome diseases as well as severe hypoglycaemia episodes present before surgery and improved some serious complications from diabetes like retinopathy, nephropathy, neuropathy, peripheral vasculopathy and cardiopathy. Conclusions: Tailored one anastomosis gastric bypass in BMI 24-34 C peptide zero diabetic patients eliminated the use of rapid insulin, reduced to only one injection per day long-lasting insulin and improved the glycemic control. After surgery disappear metabolic syndrome and severe hypoglycaemia episodes and improves significantly retinopathy, neuropathy, nephropathy, peripheral vasculopathy and cardiopathy.

  5. Ischemic colitis after mesotherapy combined with anti-obesity medications

    Institute of Scientific and Technical Information of China (English)

    Jong; Bin; Kim; Won; Moon; Seun; Ja; Park; Moo; In; Park; Kyu-Jong; Kim; Jae; Nam; Lee; Seong; Joo; Kang; Lee; La; Jang; Hee; Kyung; Chang

    2010-01-01

    Mesotherapy and anti-obesity medications are gradually gaining worldwide popularity for purposes of body contouring and weight loss.Their adverse effects are various,but there is a tendency to disregard them.Ischemic colitis is one of the most common diseases associated with non-obstructive blood vessel disorders.However,there have been no case reports about the adverse effects resulting from mesotherapy only or in combination with anti-obesity medications.We report on an interesting case of ischemic coliti...

  6. Intestinal obstruction after Roux-en-Y gastric bypass by Higa's technique for treatment of morbid obesity: radiological aspects

    International Nuclear Information System (INIS)

    Objective: The aim of this study is to describe the main radiological aspects of postoperative intestinal obstruction in patients submitted to Roux-en-Y gastric bypass by means of the Higa's technique. Materials and methods: A total of 10 patients presenting with postoperative intestinal obstruction following a gastric reduction procedure were evaluated in the period between November 2001 and April 2006, in seven different medical centers. Results: In the ten patients, the obstruction occurred in the small bowel, five of them because of internal hernias, three because of adhesions, one because of an umbilical hernia and one because of intussusception. Four patients presented obstruction early in the postoperative period (by the seventh post-op day), and six, late in the postoperative period (between the third month and the fifth year). Conclusion: All of the cases of intestinal obstruction were found in the small bowel. Internal hernia was the most frequent cause, followed by adhesion. Other causes included umbilical hernia and intussusception. (author)

  7. Roux-en-Y gastric bypass alleviates hypertension and is associated with an increase in mid-regional pro-atrial natriuretic peptide in morbid obese patients

    DEFF Research Database (Denmark)

    Bonfils, Peter K; Taskiran, Mustafa; Damgaard, Morten;

    2015-01-01

    OBJECTIVE: To examine 24-h blood pressure (24BP), systemic haemodynamics and the effect of sodium intake on 24BP in obese patients before and after gastric bypass surgery [laparoscopic Roux-en-Y gastric bypass (LRYGB)], and to determine whether weight loss from LRYGB might be related to an increase...... effect of high versus low sodium intake on 24BP was evaluated before and 12 months after LRYGB. RESULTS: Six weeks after LRYGB, the average weight loss was 20 kg, with a further 21 kg weight loss 1 year after surgery. In hypertensive patients, 24BP was significantly reduced at 6 weeks, but not 1 year...... prior to surgery in hypertensive patients and increased by 77% 1 year after the operation. In normotensive patients, preoperative concentrations were normal and increased only by 6%. High sodium intake induced plasma volume expansion, increased stroke volume and cardiac output, but no significant change...

  8. Activation of natriuretic peptides and the sympathetic nervous system following Roux-en-Y gastric bypass is associated with gonadal adipose tissues browning

    OpenAIRE

    Neinast, Michael D.; Frank, Aaron P.; Zechner, Juliet F.; Quanlin Li; Lavanya Vishvanath; Palmer, Biff F.; Vincent Aguirre; Gupta, Rana K.; Clegg, Deborah J.

    2015-01-01

    Objective: Roux-en-Y gastric bypass (RYGB) is an effective method of weight loss and remediation of type-2 diabetes; however, the mechanisms leading to these improvements are unclear. Additionally, adipocytes within white adipose tissue (WAT) depots can manifest characteristics of brown adipocytes. These ‘BRITE/beige’ adipocytes express uncoupling protein 1 (UCP1) and are associated with improvements in glucose homeostasis and protection from obesity. Interestingly, atrial and B-type natriure...

  9. Current evidence for a role of GLP-1 in Roux-en-Y gastric bypass-induced remission of type 2 diabetes

    DEFF Research Database (Denmark)

    Rhee, N A; Vilsbøll, T; Knop, F K

    2012-01-01

    Weight-reducing surgical procedures such as Roux-en-Y gastric bypass (RYGB) have proven efficient as means of decreasing excess body weight. Furthermore, some studies report that up to 80% of patients with type 2 diabetes mellitus (T2DM) undergoing RYGB experience complete remission of their T2DM......-induced remission of T2DM are lacking. This article critically evaluates the current evidence for a role of GLP-1 in RYGB-induced remission of T2DM....

  10. Night eating status and influence on body weight, body image, hunger, and cortisol pre- and post- Roux-en-Y Gastric Bypass (RYGB) surgery

    OpenAIRE

    Morrow, J; Gl{\\"}uck, M.; Lorence, M.; Flancbaum, L.; Geliebter, A.

    2008-01-01

    Night Eating Syndrome is a common disorder in severely obese individuals and may be associated with hypothalamic pituitary adrenal (HPA) axis dysregulation. This study compared night eaters (NE) and comparably obese controls (C) pre- and post-Roux-en-Y Gastric Bypass surgery at 2 and 5 months, following an overnight fast on hormonal measures associated with HPA axis and related appetite and psychological measures. There were 24 (10 NE, 14 C) clinically severely obese participants (body mass i...

  11. Exercise and Weight Loss Improve Muscle Mitochondrial Respiration, Lipid Partitioning, and Insulin Sensitivity After Gastric Bypass Surgery.

    Science.gov (United States)

    Coen, Paul M; Menshikova, Elizabeth V; Distefano, Giovanna; Zheng, Donghai; Tanner, Charles J; Standley, Robert A; Helbling, Nicole L; Dubis, Gabriel S; Ritov, Vladimir B; Xie, Hui; Desimone, Marisa E; Smith, Steven R; Stefanovic-Racic, Maja; Toledo, Frederico G S; Houmard, Joseph A; Goodpaster, Bret H

    2015-11-01

    Both Roux-en-Y gastric bypass (RYGB) surgery and exercise can improve insulin sensitivity in individuals with severe obesity. However, the impact of RYGB with or without exercise on skeletal muscle mitochondria, intramyocellular lipids, and insulin sensitivity index (SI) is unknown. We conducted a randomized exercise trial in patients (n = 101) who underwent RYGB surgery and completed either a 6-month moderate exercise (EX) or a health education control (CON) intervention. SI was determined by intravenous glucose tolerance test. Mitochondrial respiration and intramyocellular triglyceride, sphingolipid, and diacylglycerol content were measured in vastus lateralis biopsy specimens. We found that EX provided additional improvements in SI and that only EX improved cardiorespiratory fitness, mitochondrial respiration and enzyme activities, and cardiolipin profile with no change in mitochondrial content. Muscle triglycerides were reduced in type I fibers in CON, and sphingolipids decreased in both groups, with EX showing a further reduction in a number of ceramide species. In conclusion, exercise superimposed on bariatric surgery-induced weight loss enhances mitochondrial respiration, induces cardiolipin remodeling, reduces specific sphingolipids, and provides additional improvements in insulin sensitivity. PMID:26293505

  12. Effect of binge eating disorder on the outcomes of laparoscopic gastric bypass in the treatment of morbid obesity

    Directory of Open Access Journals (Sweden)

    Eduardo García Díaz

    2013-06-01

    Full Text Available Introduction: Previous studies about the effect of binge eating disorder (BED on the outcomes of laparoscopic gastric bypass (LGBP are controversial. These studies have not compared patients with and without BED according to the Bariatric Analysis and Reporting Outcome System (BAROS, which takes into account weight loss, correction of comorbidities, improvement in quality of life and complications. Objectives: To assess whether BED predicts worse outcomes after LGBP, according to BAROS parameters. Methods: We carried out a cohort study which included 45 morbidly obese patients operated with LGBP. Patients with preoperative BED were identified by Questionnaire on Eating and Weight Patterns-Revised and results were evaluated by BAROS system. Results: Prevalence of BED was 21.4%. Median postoperative follow-up was 12 months. BED patients experienced after LGBP lower rates of resolution of hypertension (42.9% vs. 92.9%; p = 0.025 and were complicated by stenosis of the gastrojejunal anastomosis more frequently (70% vs. 17.1%; p = 0.003 than patients without binge eating. No differences in BAROS score, percentage of excess weight loss and quality of life were found. Conclusions: BED patients experienced after LGBP lower rates of resolution of hypertension and higher rates of anastomotic stenosis. BAROS score, weight loss and quality of life are comparable to that of patients without.

  13. Management of Refractory Noninsulinoma Pancreatogenous Hypoglycemia Syndrome with Gastric Bypass Reversal: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Bhavana B. Rao

    2015-01-01

    Full Text Available Background. Roux-en-Y gastric bypass (RYGB is a commonly performed, effective bariatric procedure; however, rarely, complications such as postprandial hypoglycemia due to noninsulinoma pancreatogenous hypoglycemia syndrome (NIPHS may ensue. Management of refractory NIPHS is challenging. We report a case that was successfully treated with RYGB reversal. Case Report. A 58-year-old male with history of RYGB nine months earlier for morbid obesity presented for evaluation of postprandial, hypoglycemic seizures. Testing for insulin level, insulin antibodies, oral hypoglycemic agents, pituitary axis hormone levels, and cortisol stimulation was unrevealing. Computed tomography (CT scan of the abdomen was unremarkable. A 72-hour fast was completed without hypoglycemia. Mixed meal testing demonstrated endogenous hyperinsulinemic hypoglycemia (EHH and selective arterial calcium stimulation testing (SACST was positive. Strict dietary modifications, maximal medical therapy, gastrostomy tube feeding, and stomal reduction failed to alleviate symptoms. Ultimately, he underwent laparoscopic reversal of RYGB. Now, 9 months after reversal, he has markedly reduced hypoglycemia burden. Discussion. Hyperfunctioning islets secondary to exaggerated incretin response and altered intestinal nutrient delivery are hypothesized to be causative in NIPHS. For refractory cases, there is increasing skepticism about the safety and efficacy of pancreatic resection. RYGB reversal may be successful.

  14. Serious adverse events reported for anti-obesity medicines

    DEFF Research Database (Denmark)

    Aagaard, L; Hallgreen, C E; Hansen, Ebba Holme

    2016-01-01

    BACKGROUND: Use of anti-obesity medicines has been linked with serious cardiac and psychiatric adverse events (AEs). Spontaneous reports can provide information about serious, rare and unknown AEs occurring after time of marketing. In Europe, information about AEs reported for anti...... to 2014 and located in EV were analysed. AE data were categorised with respect to time, age and sex of patient/consumer, type of reporter, category and seriousness of reported AEs and medicines. Consumer AE reports were compared with reports from other types of reporters with respect to age and sex...... to share and seriousness of AEs, type of AEs (SOC) and medicines (ATC level 5). CONCLUSIONS: Many serious AEs were found for anti-obesity medicines in EV, and consumers contributed with a relatively high share of reports. Although several products have been withdrawn from the market and new medicines...

  15. Anti-obesity activity of the marine carotenoid fucoxanthin.

    Science.gov (United States)

    Gammone, Maria Alessandra; D'Orazio, Nicolantonio

    2015-04-01

    Nowadays the global tendency towards physical activity reduction and an augmented dietary intake of fats, sugars and calories is leading to a growing propagation of overweight, obesity and lifestyle-related diseases, such diabetes, hypertension, dyslipidemia and metabolic syndrome. In particular, obesity, characterized as a state of low-level inflammation, is a powerful determinant both in the development of insulin resistance and in the progression to type 2 diabetes. A few molecular targets offer hope for anti-obesity therapeutics. One of the keys to success could be the induction of uncoupling protein 1 (UCP1) in abdominal white adipose tissue (WAT) and the regulation of cytokine secretions from both abdominal adipose cells and macrophage cells infiltrated into adipose tissue. Anti-obesity effects of fucoxanthin, a characteristic carotenoid, exactly belonging to xanthophylls, have been reported. Nutrigenomic studies reveal that fucoxanthin induces UCP1 in abdominal WAT mitochondria, leading to the oxidation of fatty acids and heat production in WAT. Fucoxanthin improves insulin resistance and decreases blood glucose levels through the regulation of cytokine secretions from WAT. The key structure of anti-obesity effect is suggested to be the carotenoid end of the polyene chromophore, which contains an allenic bond and two hydroxyl groups. Fucoxanthin, which can be isolated from edible brown seaweeds, recently displayed its many physiological functions and biological properties. We reviewed recent studies and this article aims to explain essential background of fucoxanthin, focusing on its promising potential anti-obesity effects. In this respect, fucoxanthin can be developed into promising marine drugs and nutritional products, in order to become a helpful functional food. PMID:25871295

  16. Anti-Obesity Activity of the Marine Carotenoid Fucoxanthin

    Directory of Open Access Journals (Sweden)

    Maria Alessandra Gammone

    2015-04-01

    Full Text Available Nowadays the global tendency towards physical activity reduction and an augmented dietary intake of fats, sugars and calories is leading to a growing propagation of overweight, obesity and lifestyle-related diseases, such diabetes, hypertension, dyslipidemia and metabolic syndrome. In particular, obesity, characterized as a state of low-level inflammation, is a powerful determinant both in the development of insulin resistance and in the progression to type 2 diabetes. A few molecular targets offer hope for anti-obesity therapeutics. One of the keys to success could be the induction of uncoupling protein 1 (UCP1 in abdominal white adipose tissue (WAT and the regulation of cytokine secretions from both abdominal adipose cells and macrophage cells infiltrated into adipose tissue. Anti-obesity effects of fucoxanthin, a characteristic carotenoid, exactly belonging to xanthophylls, have been reported. Nutrigenomic studies reveal that fucoxanthin induces UCP1 in abdominal WAT mitochondria, leading to the oxidation of fatty acids and heat production in WAT. Fucoxanthin improves insulin resistance and decreases blood glucose levels through the regulation of cytokine secretions from WAT. The key structure of anti-obesity effect is suggested to be the carotenoid end of the polyene chromophore, which contains an allenic bond and two hydroxyl groups. Fucoxanthin, which can be isolated from edible brown seaweeds, recently displayed its many physiological functions and biological properties. We reviewed recent studies and this article aims to explain essential background of fucoxanthin, focusing on its promising potential anti-obesity effects. In this respect, fucoxanthin can be developed into promising marine drugs and nutritional products, in order to become a helpful functional food.

  17. Screening of anti-obesity agent from herbal mixtures.

    Science.gov (United States)

    Roh, Changhyun; Jung, Uhee; Jo, Sung-Kee

    2012-01-01

    Globally, one in three of the World's adults are overweight and one in 10 is obese. By 2015, World Health Organization (WHO) estimates the number of chubby adults will balloon to 2.3 billion--Equal to the combined populations of China, Europe and the United States. The discovery of bioactive compounds from herbs is one possible way to control obesity and to prevent or reduce the risks of developing various obesity-related diseases. In this study, we screened anti-obesity agents such as methyl gallate from the herbal composition known as HemoHIM that actively inhibits lipid formation as evidenced by Oil Red O staining and triglyceride (TG) contents in 3T3-L1 adipocytes, suggesting their use as an anti-obesity agent. Furthermore, the amount of glycerol released from cells into the medium had increased by treatment of methyl gallate in a concentration-dependent manner. The present study suggests that a promising anti-obesity agent like methyl gallate might be of therapeutic interest for the treatment of obesity. PMID:22447026

  18. Screening of Anti-Obesity Agent from Herbal Mixtures

    Directory of Open Access Journals (Sweden)

    Sung-Kee Jo

    2012-03-01

    Full Text Available Globally, one in three of the World’s adults are overweight and one in 10 is obese. By 2015, World Health Organization (WHO estimates the number of chubby adults will balloon to 2.3 billion—Equal to the combined populations of China, Europe and the United States. The discovery of bioactive compounds from herbs is one possible way to control obesity and to prevent or reduce the risks of developing various obesity-related diseases. In this study, we screened anti-obesity agents such as methyl gallate from the herbal composition known as HemoHIM that actively inhibits lipid formation as evidenced by Oil Red O staining and triglyceride (TG contents in 3T3-L1 adipocytes, suggesting their use as an anti-obesity agent. Furthermore, the amount of glycerol released from cells into the medium had increased by treatment of methyl gallate in a concentration-dependent manner. The present study suggests that a promising anti-obesity agent like methyl gallate might be of therapeutic interest for the treatment of obesity.

  19. Increased intravenous morphine self-administration following Roux-en-Y gastric bypass in dietary obese rats.

    Science.gov (United States)

    Biegler, Jessica M; Freet, Christopher S; Horvath, Nelli; Rogers, Ann M; Hajnal, Andras

    2016-05-01

    Roux-en-Y gastric bypass (RYGB) surgery is a commonly performed and very effective method to achieve significant, long-term weight loss. Opioid analgesics are primarily used to manage postoperative pain as fewer alternative medication options are available for bariatric surgery patients than for the general population. Recent clinical studies support a greater risk for substance use following bariatric surgery, including an increased use of opioid medications. The present study is the first to study morphine self-administration in a rat model of RYGB. High fat diet-induced obese (HFD-DIO) rats underwent RYGB (n=14) or sham-surgery with ad libitum HFD (SHAM, n=14) or a restricted amount that resulted in weight matched to the RYGB cohort (SHAM-WM, n=8). An additional normal-diet (ND, n=7), intact (no surgery) group of rats was included. Two months after the surgeries, rats were fitted with jugular catheters and trained on a fixed ratio-2 lick task to obtain morphine intravenously. Both morphine-seeking (number of licks on an empty spout to obtain morphine infusion) and consumption (number of infusion) were significantly greater in RYGB than any control group beginning on day 3 and reached a two-fold increase over a period of two weeks. These findings demonstrate that RYGB increases motivation for taking morphine and that this effect is independent of weight loss. Further research is warranted to reveal the underlying mechanisms and to determine whether increased morphine use represents a risk for opioid addiction following RYGB. Identifying risk factors preoperatively could help with personalized postoperative care to prevent opioid abuse and addiction. PMID:26304761

  20. Metabolic responses to xenin-25 are altered in humans with Roux-en-Y gastric bypass surgery.

    Science.gov (United States)

    Sterl, Karin; Wang, Songyan; Oestricker, Lauren; Wallendorf, Michael J; Patterson, Bruce W; Reeds, Dominic N; Wice, Burton M

    2016-08-01

    Xenin-25 (Xen) is a neurotensin-related peptide secreted by a subset of enteroendocrine cells located in the proximal small intestine. Many effects of Xen are mediated by neurotensin receptor-1 on neurons. In healthy humans with normal glucose tolerance (NGT), Xen administration causes diarrhea and inhibits postprandial glucagon-like peptide-1 (GLP-1) release but not insulin secretion. This study determines (i) if Xen has similar effects in humans with Roux-en-Y gastric bypass (RYGB) and (ii) whether neural pathways potentially mediate effects of Xen on glucose homeostasis. Eight females with RYGB and no history of type 2 diabetes received infusions with 0, 4 or 12pmol Xen/kg/min with liquid meals on separate occasions. Plasma glucose and gastrointestinal hormone levels were measured and insulin secretion rates calculated. Pancreatic polypeptide and neuropeptide Y levels were surrogate markers for parasympathetic input to islets and sympathetic tone, respectively. Responses were compared to those in well-matched non-surgical participants with NGT from our earlier study. Xen similarly increased pancreatic polypeptide and neuropeptide Y responses in patients with and without RYGB. In contrast, the ability of Xen to inhibit GLP-1 release and cause diarrhea was severely blunted in patients with RYGB. With RYGB, Xen had no statistically significant effect on glucose, insulin secretory, GLP-1, glucose-dependent insulinotropic peptide, and glucagon responses. However, insulin and glucose-dependent insulinotropic peptide secretion preceded GLP-1 release suggesting circulating GLP-1 does not mediate exaggerated insulin release after RYGB. Thus, Xen has unmasked neural circuits to the distal gut that inhibit GLP-1 secretion, cause diarrhea, and are altered by RYGB. PMID:27288245

  1. Efficacy of Laparoscopic Mini Gastric Bypass for Obesity and Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis

    Directory of Open Access Journals (Sweden)

    Yingjun Quan

    2015-01-01

    Full Text Available Background. Controversies on the utility of laparoscopic mini gastric bypass (LMGB in weight loss and type 2 diabetes mellitus (T2DM control still exist. Methods. We conducted a comprehensive literature search of PubMed, EMBASE, and Cochrane Library. Review Manager was used to perform the meta-analysis and the weighted mean difference (WMD and/or odds ratio with 95% confidence interval (95% CI were used to evaluate the overall size effect. Results. The literature search identified 16 studies for systematic review and 15 articles for meta-analysis. Compared with LAGB, LSG, and LRYGB, LMGB showed significant weight loss [WMD, −6.58 (95% CI, −9.37, −3.79, P<0.01 (LAGB; 2.86 (95% CI, 1.40, 5.83, P=0.004 (LSG; 10.33 (95% CI, 4.30, 16.36, P<0.01 (LRYGB] and comparable/higher T2DM remission results [86.2% versus 55.6%, P=0.06 (LAGB; 89.1% versus 76.3%, P=0.004 (LAGB; 93.4% versus 77.6%, P=0.006 (LAGB]; LMGB also had shorter learning curve and less operation time than LRYGB [WMD, −35.2 (95% CI, −46.94, −23.46]. Conclusions. LMGB appeared to be effective in weight loss and T2DM remission and noninferior to other bariatric surgeries. However, clinical utility of LMGB needs to be further validated by future prospective randomized controlled trials.

  2. Quality assessment and anti-obesity activity of Stellaria media (Linn.) Vill

    OpenAIRE

    Rani Neerja; Vasudeva Neeru; Sharma Surendra

    2012-01-01

    Abstract Background Obesity is recognized as a social problem, associated with serious health risks and increased mortality. Numerous trials have been conducted to find and develop new anti-obesity drugs through herbal sources to minimize side effects associated with the present anti-obesity drugs. The present study was designed to evaluate the quality control parameters, quantitative phytochemical analysis (total phenolic, total flavonoids and total saponin content), and the anti-obesity eff...

  3. Diabetes surgery in type 2 BMI 24-29 vs IMC 30-34 diabetic patients: is there differences among restrictive, malabsorptive and gastric bypass procedures?

    Directory of Open Access Journals (Sweden)

    M. Garciacaballero

    2013-01-01

    Full Text Available Diabetes mellitus (DM is a public health problem with a prevalence of 345 million people worldwide that it may double by the year 2030 and have a high costs and mortality. Gastrointestinal surgery is accepted as a form of treatment that was already suggested for obese in 1987 by Pories, confirmed for obese patients by the meta-analysis of Buchwald and the direct comparison of gastric bypass with medical treatment in the study of Schauer that demonstrate a 4 fold greater resolution rate of DM with surgery. Improvement occurs immediately after surgery, before the patients lose weight in with BMI > 35; but there is doubt if the existent evidence is enough to extrapolate these results to patients with BMI < 35 and especially with BMI < 30, in spite that four reviews in patients with this BMI and DM2 demonstrated the same results when stomach, duodenum and part of jejunum is bypassed as happen gastric bypass (better results with this of one anastomosis than of two anastomosis, Rouxen-Y BPD. For patients with a BMI between 30 and 35 restrictive techniques: LAGB and SGL are good but not better than the mixed: RYGB, BAGUA, or SG-DJB with remission from 60 to 100%, minor in the derivative: BPD and above on the IID with a 81% of remission. There are no differences in the metabolic control in comparison to the obese, It is progressively better with DJB, SDS, IID and BAGUA especially in patients who do not require insulin, have less time with disease, have normal C peptide levels, and not so much relation with the initial BMI that is only important to decide the degree of restriction. Although several mechanisms has been suggesed for explaining these results such as caloric intake, hormonal changes, bypass of the anterior or early stimulation of posterior intestine, fundectomy, intestinal gluconeogenesis and others, new ones will appear in the near future.

  4. Roux-en-Y Gastric Bypass and Vertical Banded Gastroplasty Induce Long-Term Changes on the Human Gut Microbiome Contributing to Fat Mass Regulation

    DEFF Research Database (Denmark)

    Tremaroli, Valentina; Karlsson, Fredrik; Werling, Malin;

    2015-01-01

    Bariatric surgery is currently the most effective procedure for the treatment of obesity. Given the role of the gut microbiota in regulating host metabolism and adiposity, we investigated the long-term effects of bariatric surgery on the microbiome of patients randomized to Roux-en-Y gastric bypass...... or vertical banded gastroplasty and matched for weight and fat mass loss. The two surgical procedures induced similar and durable changes on the gut microbiome that were not dependent on body mass index and resulted in altered levels of fecal and circulating metabolites compared with obese controls...

  5. Cardiovascular effects of current and future anti-obesity drugs

    DEFF Research Database (Denmark)

    Comerma-Steffensen, Simon; Grann, Martin; Andersen, Charlotte;

    2014-01-01

    The prevalence of obesity increases and is associated with increases in co-morbidities e.g. type 2 diabetes, hyperlipidemia, hypertension, obstructive sleep apnea, heart disease, stroke, asthma, several forms of cancer, depression, and may result in reduction of expected remaining lifespan. We have...... to be investigated. For type 2 diabetes, new drug classes with possible advantageous cardiovascular profiles, e.g. GLP-1 analogues and sodium-glucose co-transport type 2 inhibitors, are associated with weight loss and are currently being evaluated as anti-obesity drugs....

  6. Screening of Anti-Obesity Agent from Herbal Mixtures

    OpenAIRE

    Sung-Kee Jo; Uhee Jung; Changhyun Roh

    2012-01-01

    Globally, one in three of the World’s adults are overweight and one in 10 is obese. By 2015, World Health Organization (WHO) estimates the number of chubby adults will balloon to 2.3 billion—Equal to the combined populations of China, Europe and the United States. The discovery of bioactive compounds from herbs is one possible way to control obesity and to prevent or reduce the risks of developing various obesity-related diseases. In this study, we screened anti-obesity agents such as methyl ...

  7. Small lipidated anti-obesity compounds derived from neuromedin U.

    Science.gov (United States)

    Micewicz, Ewa D; Bahattab, Omar S O; Willars, Gary B; Waring, Alan J; Navab, Mohamad; Whitelegge, Julian P; McBride, William H; Ruchala, Piotr

    2015-08-28

    A small library of truncated/lipid-conjugated neuromedin U (NmU) analogs was synthesized and tested in vitro using an intracellular calcium signaling assay. The selected, most active analogs were then tested in vivo, and showed potent anorexigenic effects in a diet-induced obese (DIO) mouse model. The most promising compound, NM4-C16 was effective in a once-weekly-dose regimen. Collectively, our findings suggest that short, lipidated analogs of NmU are suitable leads for the development of novel anti-obesity therapeutics. PMID:26204509

  8. Outcomes of Roux-en-Y gastric bypass surgery for severely obese patients with type 1 diabetes: a case series report

    Directory of Open Access Journals (Sweden)

    Carlos E Mendez

    2010-08-01

    Full Text Available Carlos E Mendez, Robert J Tanenberg, Walter PoriesDiabetes and Obesity Institute, East Carolina University, Greenville, NC, USAAbstract: Roux-en-Y gastric bypass surgery (RYGB reverses type 2 diabetes (DM2 in approximately 83% of patients with morbid or severe obesity. This procedure has been performed in small numbers of severely obese patients with type 1 diabetes (DM1, but the impact on glycemic control and insulin requirement in this population has not been widely described. We report three patients with DM1 and severe obesity that underwent RYGB. Weight, glycemic control, and insulin requirements before and one year after the procedure were compared. Significant weight loss was achieved by all three patients but insulin requirements decreased in only 2 patients. In contrast, glycemic control (A1C remained suboptimal in all three patients up to one year after the surgery. These findings suggest that RYGB leads to important weight loss and positively affects insulin sensitivity. However, reaching optimal glycemic control in patients with DM1 diabetes remains challenging due to persisting insulin deficiency.Keywords: gastric bypass, Roux-en-Y, obesity, diabetes, insulin

  9. Evaluation of laparoscopic sleeve gastrectomy compared with laparoscopic Roux-en-Y gastric bypass for people with morbid obesity: A systematic review and meta-analysis

    Science.gov (United States)

    Arabi Basharic, Fateme; Olyaee Manesh, Alireza; Ranjbar Ezzat Abadi, Mohammad; Shiryazdi, Seyed Mostafa; Shabahang, Hussein; Jangjoo, Ali

    2016-01-01

    Background: Prevalence of obesity in the world, in both developed and developing countries, is growing rapidly. Bariatric surgery is now accepted as the treatment for morbid obesity. Objective: This study compares laparoscopic sleeve gastrectomy's effectiveness (LSG) with the most common bariatric surgery, laparoscopic Roux-en-Y (LRYGB) gastric bypass. Methods: A systematic review was performed using relevant search data bases, including Cochrane library, PubMed, Magi ran, Iranmedex, SID and Trip database, with no time limit. Data bases were searched until July 2014 for randomized control trials. The studied population included people aged between 18–60 years, with BMI≥35 and at least one obesity-related disease, or people with BMI≥40. BMI change, as the research outcome, was investigated at least in one-year follow-up period. Cochrane criteria were used to assess quality of studies. The results were extracted from the articles. Results: In total, 384 articles were obtained in the search; six RCTs were included in this study. There was no significant difference between the two laparoscopic sleeve gastrectomy and laparoscopic Roux-en-Y gastric bypass procedures in BMI, and both groups were similar in weight loss CI [-.1.31, 0.43], p=0.32. Conclusion: The two procedures of bariatric surgery are effective and reliable treatments. Performing more trial studies with greater sample size and longer follow-up period for making final decision in selecting a certain surgical procedure is essential.

  10. Gastric bypass surgery

    Science.gov (United States)

    ... Morabito A. Long-term prevention of mortality in morbid obesity through bariatric surgery: A systematic review and meta- ... ncbi.nlm.nih.gov/pubmed/21245741 . Richards WO. Morbid obesity. In: Townsend Jr. CM, Beauchamp RD, Evers BM, ...

  11. Weighing the Options: Gastric Sleeve Surgery

    Medline Plus

    Full Text Available ... over the past 10 years. Absolutely. The gold standard is the laparoscopic roux-en-y gastric bypass, ... an alternative to the other two. The gold standard is the roux-en-y gastric bypass. The ...

  12. Efecto del bypass gástrico en el síndrome metabólico y en el riesgo cardiovascular Effect of gastric bypass on the metabolic syndrome and on cardiovascular risk

    Directory of Open Access Journals (Sweden)

    J. Ocón

    2010-02-01

    are a high risk of developing cardiovascular disease (CVD. The aim of this study was to determine the prevalence of the MS in morbidly obese patients enrolling in a bariatric surgery program and to evaluate the impact of weigh loss induced by gastric bypass on the MS and on the predicted 10-year cardiovascular risk. Material and methods: We studied 46 morbidly obese patients who underwent laparoscopic gastric bypass and were followed for 2 years. MS was defined following the IDF 2005 criteria and the insulin resistance (IR was calculated by using HOMA index. Risk assessment for estimating 10-year ECV risk was carried out according to Framingham score. Results: Before surgery, 67.2% of patients had IR and 60,9% met the definition of the MS. 17.3% of patients had an elevated cardiovascular risk category. 2 years after gastric bypass, the percentage of excess body weight lost was 72%. All patients restored their HOMA index and only 1 patient (3.6% had MS. Resolution of hypertension, disglucemia and dislipemia has been observed in 85%, 93.8% and 95.6% of patients. Estimated cardiovascular risk decreased from 4.5% at baseline to 1% at 2 years after surgery. Conclusions: SM is common in morbidly obese patients. Bypass gastric is associated with an improvement or resolution in cardiovascular risk factors and IR and result in a significant reduction in MS prevalence and of predicted 10-year cardiovascular risk.

  13. A novel technique of Roux-en-Y gastric bypass reversal for postprandial hyperinsulinemic hypoglycaemia: A case report

    Directory of Open Access Journals (Sweden)

    E. Qvigstad

    2016-01-01

    Conclusions: Reduction of plasma–glucose, insulin and GLP-1 excursions and symptoms were seen after gastric tube placement and partial RYGB reversal. This attenuation of GLP-1 response to feeding could reflect an adaptation to nutrients.

  14. Effect of Roux-en-Y gastric bypass surgery on ventricular function and cardiac risk factors in obese patients: a systematic review

    Directory of Open Access Journals (Sweden)

    Alireza Abdollahi Moghaddam

    2016-03-01

    Full Text Available Introduction: Weight gain and obesity are two important public health problems, which are associated with many diseases such as cardiovascular disorders. Various policies such as bariatric surgery have been proposed for the treatment of morbid obesity. Methods: PubMed and Scopus were searched thoroughly with the following search terms (roux-en-y gastric bypass surgery AND (ventricular function, OR cardiac risk factors OR heart AND (BMI OR body mass index to find the articles in which the effect of roux-en-Y gastric bypass (RYGB surgery had been evaluated in severely obese patients.Result: Out of 120 articles which were found in PubMed, and 28 records which were found in Scopus, only 18 articles fully met the inclusion criteria. Out of 2740 participants in the included studied, 1706 were patients with body mass index (BMI over 40 kg/m2 who had undergone RYGB surgery, and 1034 were control participants. Results of the studies showed that RYGB surgery could reduce BMI, and cardiac risk factors, and improve diastolic function, systolic and diastolic blood pressures, and aortic function, postoperatively.Discussion: Obesity is associated with increased risk of cardiovascular diseases, impaired cardiac function, and hypertension. It is shown that RYGB surgery reduces the serum level of biochemical markers of cardiac diseases. Cardiac structure, parasympathetic indices of autonomic function, coronary circulatory function, hypertension, epicardial fat thickness, and ventricular performance improve after bariatric surgery.Conclusions: It is concluded that RYGB surgery is an effective strategy to improve ventricular function and cardiac risk factors in morbid obese patients.

  15. Estudos endoscópico e histológico prospectivos e sequenciais da bolsa gástrica em 130 pacientes obesos mórbidos submetidos à bypass gástrico em Y-de-Roux Prospective sequential endoscopic and histologic studies of the gastric pouch in 130 morbidly obese patients submitted to Roux-en-Y gastric bypass

    Directory of Open Access Journals (Sweden)

    Attila Csendes

    2012-12-01

    Full Text Available RACIONAL: Bypass gástrico em Y-de-Roux é a operação bariátrica mais comumente realizada. Pequena bolsa gástrica é criada, deixando uma anastomose gastrojejunal estreita, com uma alça jejunal mais comprida. Muito pouco é conhecido sobre o comportamento desta bolsa em anos após o procedimento. OBJETIVO: Determinar através de estudos prospectivos endoscópico e histológico seqüenciais o tamanho da bolsa gástrica, o diâmetro da anastomose e o comportamento da infecção por H. pylori após a operação. MÉTODOS: Em 130 pacientes submetidos ao bypass gástrico foram realizadas várias avaliações sequenciais endoscópica (até 120 meses e histológica de rotina da bolsa gástrica. RESULTADOS: Após a operação, foram realizadas em média 3,6 endoscopias por paciente. Macroscopicamente quase 95% das pequenas bolsas gástricas eram normais, e o principal achado patológico foi uma úlcera marginal. Esofagite erosiva desapareceu em 93% dos pacientes. Não houve aumento no tamanho orocaudal da bolsa durante o período de observação. Não houve dilatação do diâmetro da anastomose gastrojejunal. Perto de 54% de todos os pacientes tinham mucosa fúndica normal, enquanto 18% tinham gastrite crônica ativa, coincidente com a infecção por H. pylori. Cinco pacientes tinham metaplasia intestinal. CONCLUSÃO: Com base nesta avaliação endoscópica sequencial, não houve aumento no tamanho orocaudal da bolsa gástrica, nem do diâmetro da anastomose gastrojejunal. O comportamento do H. pylori foi inconsistente e difícil de interpretar.BACKGROUND: Roux-en-Y gastric bypass is the most common performed bariatric surgery. A small gastric pouch is created, leaving a narrow gastrojejunal anastomosis, with a long jejunal limb. Very little is known regarding the behavior of this pouch years after surgery. AIM: To determine through prospective sequential endoscopic studies the size of the gastric pouch, the diameter of the anastomosis, and the

  16. Endoluminal Revision (OverStitch (TM) , Apollo Endosurgery) of the Dilated Gastroenterostomy in Patients with Late Dumping Syndrome After Proximal Roux-en-Y Gastric Bypass.

    Science.gov (United States)

    Stier, Christine; Chiappetta, Sonja

    2016-08-01

    Dumping syndrome is a long-term postoperative complication of Roux-en-Y gastric bypass procedures. Morphologically, dumping syndrome usually correlates with a dilatation of the gastroenterostomy with accelerated pouch emptying. Conservative therapy includes diet changes, complementary pharmacotherapy and, if symptoms persist, surgical revision. Surgical options include endoscopic, endoluminal surgery to constrict the gastrojejunostomy using a novel endoscopic suturing device (OverStitch(TM), Apollo). In our study, we aimed to assess the viability, safety and efficacy of this procedure in patients with late dumping; 14 patients who had developed late dumping syndrome underwent surgery using an endoscopic suturing technique (OverStitch(TM), Apollo). Late dumping was confirmed by Sigstad score and an oral glucose tolerance test (OGTT). Prior to surgery, objective analysis of pouch emptying speed was assessed by gastric scintigraphy. Surgery was performed under general anaesthesia. None of the 14 patients suffered intra- or postoperative complications. No postsurgical increase in inflammation parameters was observed. The postinterventional pain scale (visual analogue scale) showed a mean score of 0.5 (range 0-10). In 13 of the 14 patients, no dumping was observed 1-month postsurgery. The postoperative Sigstad score (3.07 ± 2.06; range 1-9) showed an impressive reduction compared with the preoperative score (12.71 ± 4.18; range 7-24) (p dumping syndrome involving minimal trauma and offering rapid reconvalescence. PMID:27318467

  17. Intestinal obstruction after Roux-en-Y gastric bypass by Higa's technique for treatment of morbid obesity: radiological aspects

    Energy Technology Data Exchange (ETDEWEB)

    Labrunie, Ester Moraes [Universidade Federal do Rio de Janeiro (UFRJ), RJ (Brazil). Faculdade de Medicina. Dept. de Radiologia]. E-mail: emlabrunie@superig.com.br; Marchiori, Edson [Universidade Federal Fluminense (UFF), Niteroi, RJ (Brazil). Faculdade de Medicina. Dept. de Radiologia

    2007-05-15

    Objective: The aim of this study is to describe the main radiological aspects of postoperative intestinal obstruction in patients submitted to Roux-en-Y gastric bypass by means of the Higa's technique. Materials and methods: A total of 10 patients presenting with postoperative intestinal obstruction following a gastric reduction procedure were evaluated in the period between November 2001 and April 2006, in seven different medical centers. Results: In the ten patients, the obstruction occurred in the small bowel, five of them because of internal hernias, three because of adhesions, one because of an umbilical hernia and one because of intussusception. Four patients presented obstruction early in the postoperative period (by the seventh post-op day), and six, late in the postoperative period (between the third month and the fifth year). Conclusion: All of the cases of intestinal obstruction were found in the small bowel. Internal hernia was the most frequent cause, followed by adhesion. Other causes included umbilical hernia and intussusception. (author)

  18. CT findings in Petersen’s hernia as a complication of bariatric surgery with a Roux-en-Y gastric bypass

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    Mauricio Álvares Salum Ximenes

    2008-12-01

    Full Text Available Objectives: To describe tomographic findings in Petersen’s herniaassociated with laparoscopic Roux-en-Y gastric bypass surgery.Methods: Two radiologists, experts in abdominal radiology,independently and retrospectively reviewed four cases of Petersen’shernia confirmed surgically in three patients, between March 2007and July 2008, who had undergone laparoscopic Roux-en-Y gastricbypass surgery with an antecolic anastomosis for treating morbidobesity. The main imaging findings were the presence and locationof abdominal distention, the herniated intestinal loop segment, thepresence of mesenteric vessel rotation and haziness of mesentericfat, the position of the Treitz angle ligament and the course of theileum. Results: In all cases, abdominal distention was located inthe upper abdomen; the herniated jejunal loop was located abovethe gastric level; mesenteric vessel rotation was associated withmesenteric fat haziness; the middle/distal ileum descended from theleft hypochondrium; and the Treiz angle was displaced anteriorly andto the right. Both examiners fully agreed with the analysis of findings.Conclusions: The association of computed tomography findingsdescribed in patients with a history of bariatric surgery is a strongpredictor of Petersen’s hernia.

  19. Gastrojejunal anastomosis stricture after laparoscopic gastric bypass: Our experience with 62 patients Estenosis de la anastomosis gastroyeyunal en el bypass gástrico laparoscópico: Nuestra experiencia con 62 pacientes

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    A. Campillo-Soto

    2010-03-01

    Full Text Available Objective: gastrojejunal stricture (GYS, not only is a common complication after laparoscopic gastric bypass (LGBP, but its frequency is about 15% according to bibliography. Our aim is to present our experience after 62 LGBP. Patients and method: from January 2004 to September-2006, we performed 62 consecutive laparoscopic gastric bypass (Wittgrove's technique. The gastrojejunal anastomosis is performed with auto suture material type CEAA No 21 termino-lateral (ILS, Ethicon. In 4 cases (6.45% was converted to laparotomy, perform the anastomosis in the same way. Monitoring has a range of 3-35 months, conducted in 61 patients because one patient died of pulmonary thromboembolism in the immediate postoperative period after reoperation, after two weeks of gastric bypass, by necrosis of a small fragment of the remnant gastric. In all patients with persistent feeding intolerance were performed barium transit and/or gastroscopy. When gastrojejunal stricture showed proceeded to endoscopic pneumatic dilation (recommending dilate the anastomosis to a maximum 1.5 cm. Results: five cases (8.1% developed a gastrojejunal stricture, in 4 of these cases the initial diagnosis was made by barium transit and in 1 case by endoscopy. Two patients had a history of digestive bleeding that required endoscopic sclerosis of the bleeding lesion (circumferentially sclerosis within 48 hours of surgery and sclerosis of bleeding points. All cases were resolved by endoscopic dilatation. At follow-up has not been detected re-stricture. Conclusion: Clinically, gastrojejunal stricture results in a progressive oral intolerance, revealing stenosis between 1 and 3 months postoperatively. The situations of sclerosis of the bleeding lesions favor, especially in cases of extensive sclerosis. In cases of suspected barium transit offers us a high diagnostic yield. Endoscopic dilatation resolved, so far, all cases.Objetivo: la estenosis de la anastomosis gastroyeyunal representa una

  20. Carotid intima-media thickness is reduced 12 months after gastric bypass surgery in obese patients with type 2 diabetes or impaired glucose tolerance

    DEFF Research Database (Denmark)

    Lundby-Christensen, Louise; Tarnow, Lise; Hansen, Dorte L;

    2014-01-01

    AIM: To investigate whether Roux-en-Y gastric bypass surgery (RYGB) - an in vivo model for normalisation of hyperglycaemia - improves carotid intima-media thickness (IMT) in patients with type 2 diabetes (T2D)/impaired glucose tolerance (IGT) and normal glucose tolerance (NGT). METHODS......: Observational prospective study, 34 obese patients (T2D (n = 14)/IGT (n = 4), and NGT (n = 16)) were investigated before and six and 12months after RYGB. RESULTS: Mean carotid IMT was significantly reduced 12months after RYGB in patients with T2D/IGT (-0.041 mm (95% CI -0.069; -0.012, p = 0.005)) but not in...... patients with NGT (-0.010 mm (-0.039; 0.020, p = 0.52)). The between-group difference was not significant (p=0.13). Twelve months after RYGB, patients with respectively T2D/IGT and NGT demonstrated changes in weight: -29.9 kg, p<0.001/-30.6 kg, p < 0.001, HbA1c: -0.7%, p < 0.001/-0.1%, p = 0.33, systolic...

  1. Oxyntomodulin Identified as a Marker of Type 2 Diabetes and Gastric Bypass Surgery by Mass-spectrometry Based Profiling of Human Plasma

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    Nicolai J. Wewer Albrechtsen

    2016-05-01

    Full Text Available Low-abundance regulatory peptides, including metabolically important gut hormones, have shown promising therapeutic potential. Here, we present a streamlined mass spectrometry-based platform for identifying and characterizing low-abundance regulatory peptides in humans. We demonstrate the clinical applicability of this platform by studying a hitherto neglected glucose- and appetite-regulating gut hormone, namely, oxyntomodulin. Our results show that the secretion of oxyntomodulin in patients with type 2 diabetes is significantly impaired, and that its level is increased by more than 10-fold after gastric bypass surgery. Furthermore, we report that oxyntomodulin is co-distributed and co-secreted with the insulin-stimulating and appetite-regulating gut hormone glucagon-like peptide-1 (GLP-1, is inactivated by the same protease (dipeptidyl peptidase-4 as GLP-1 and acts through its receptor. Thus, oxyntomodulin may participate with GLP-1 in the regulation of glucose metabolism and appetite in humans. In conclusion, this mass spectrometry-based platform is a powerful resource for identifying and characterizing metabolically active low-abundance peptides.

  2. PYY-Dependent Restoration of Impaired Insulin and Glucagon Secretion in Type 2 Diabetes following Roux-En-Y Gastric Bypass Surgery.

    Science.gov (United States)

    Ramracheya, Reshma D; McCulloch, Laura J; Clark, Anne; Wiggins, David; Johannessen, Helene; Olsen, Magnus Kringstad; Cai, Xing; Zhao, Chun-Mei; Chen, Duan; Rorsman, Patrik

    2016-05-01

    Roux-en-Y gastric bypass (RYGB) is a weight-reduction procedure resulting in rapid resolution of type 2 diabetes (T2D). The role of pancreatic islet function in this restoration of normoglycemia has not been fully elucidated. Using the diabetic Goto-Kakizaki (GK) rat model, we demonstrate that RYGB restores normal glucose regulation of glucagon and insulin secretion and normalizes islet morphology. Culture of isolated islets with serum from RYGB animals mimicked these effects, implicating a humoral factor. These latter effects were reversed following neutralization of the gut hormone peptide tyrosine tyrosine (PYY) but persisted in the presence of a glucagon-like peptide-1 (GLP-1) receptor antagonist. The effects of RYGB on secretion were replicated by chronic exposure of diabetic rat islets to PYY in vitro. These findings indicate that the mechanism underlying T2D remission may be mediated by PYY and suggest that drugs promoting PYY release or action may restore pancreatic islet function in T2D. PMID:27117413

  3. Characterization of taurine as anti-obesity agent in C. elegans

    OpenAIRE

    2010-01-01

    Background Taurine plays an important role in reducing physiological stress. Recent studies indicated that taurine may serve as an anti-obesity agent at the cellular level. This study characterizes taurine’s potential anti-obesity function in C. elegans, which have become a popular in vivo model for understanding the regulatory basis of lipid biosynthesis and deposition. Methods Two strains of C. elegans were raised on a normal or high-fat diet: N2 (normal) and RB1600, a mutant in tub-1 that ...

  4. Anti-obesity effects of black ginseng extract in high fat diet-fed mice

    OpenAIRE

    Lee, Mi Ra; Kim, Byung Chan; Kim, Ran; Oh, Hyun In; Kim, Hyun Kyoung; Choi, Kang Ju; Sung, Chang Keun

    2013-01-01

    Black ginseng is produced by a repeated steaming process. The aim of this study was to investigate the anti-obesity effects of black ginseng ethanol extract (BG-EE) in high fat (HF) diet-fed mice. Two groups were fed either a normal control (NC) diet or a HF diet (45% kcal fat). The other three groups were given a HF diet supplemented with 1% BG-EE, 3% BG-EE, and 5% BG-EE for 12 wk. The anti-obesity effects of the BG-EE supplement on body weight, the development of fat mass, and lipid mechani...

  5. One anastomosis gastric bypass: a simple, safe and efficient surgical procedure for treating morbid obesity El bypass gástrico de una anastómosis: un procedimiento simple, seguro y eficaz para tratar la obesidad mórbida

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    M. García-Caballero

    2004-11-01

    Full Text Available The One Anastomosis Gastric Bypass has been developed from the Mini Gastric Bypass procedure as originally described by Robert Rutledge. The modification of the original procedure consists of making a latero-lateral gastro-jejunal anastomosis instead of a termino-lateral anastomosis, as is carried out as described in the original procedure. The rationale for these changes is to try to reduce exposure of the gastric mucosa to biliopancreatic secretions because of their potentially carcinogenic effects with longer term exposure, which is the major criticism of the original technique. If we fix the jejunal loop to the gastric pouch some centimetres up to the gastro-jejunal anastomosis the biliopancreatic secretions have less possibility of coming into the gastric cavity (gravity force. Furthermore, if the anastomosis is latero-lateral this possibility is reduced even more. In addition, the intestinal loop reinforces the staple line against disruption, and also the gastric pouch against dilatation.El Bypass Gástrico de Una Anastomosis se ha desarrollado a partir del Mini Bypass Gástrico descrito por Robert Rutledge. La modificación del procedimiento original consiste en hacer una anastomosis latero-lateral en lugar de termino-lateral como se hace en la técnica original. Este cambio intenta reducir la exposición de la mucosa gástrica a la secreción bilio-pancreática, evitando así el posible efecto carcinogénico de la exposición crónica que constituye la más importante crítica del procedimiento original. Al fijar el asa de yeyuno a la nueva bolsa gástrica unos centímetros por encima de la anastomosis gastro-yeyunal, la secreción bilio-pancreática tiene menos posibilidades de entrar en la cavidad gástrica (fuerza de gravedad. Al ser la anastomosis latero-lateral esta posibilidad se reduce aún más. Además, el asa de yeyuno refuerza la línea de grapas contra su disrupción y previene la posible dilatación de la bolsa gástrica.

  6. CHANGES IN QUALITY OF LIFE AFTER SHORT AND LONG TERM FOLLOW-UP OF ROUX-EN-Y GASTRIC BYPASS FOR MORBID OBESITY

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    Rafael M. LAURINO NETO

    2013-09-01

    Full Text Available Context It is unclear whether health-related quality of life (HRQL is sustained in a long-term follow-up of morbidly obese patients who underwent Roux-en-Y gastric bypass (RYGB. Objective This study aims to analyze the HRQL changes following RYGB in short and long-term follow-up. Methods We compared the health-related quality of life among three separate patient groups, using the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36. Group A - 50 preoperative morbidly obese patients; Group B - 50 RYGB patients 1-2 years post-surgery; Group C - 50 RYGB patients more than 7 years post-surgery. Results The groups were similar for gender, age and body mass index before surgery. We observed that physical functioning, social function, emotional role functioning and mental health scales did not vary between the three groups. The physical role functioning scale was unchanged in the short-term and decreased compared to the preoperative scale in the long-term follow-up. Bodily pain improved after the operation but returned to the initial level after 7 years. The vitality and general health perceptions improved after the operation and maintained these results after 7 years compared with the preoperative perceptions. Conclusions RYGB improved health-related quality of life in three SF-36 domains (bodily pain, general health perceptions and vitality in the short-term and two SF-36 domains (general health perceptions and vitality in the long-term.

  7. Super obese behave different from simple and morbid obese patients in the changes of body composition after tailored one anastomosis gastric bypass (BAGUA

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    M. Garciacaballero

    2014-05-01

    Full Text Available Introduction: Super obese patients behave different from simple and morbid obese patients when they reach final changes of body composition (BC after bariatric surgery. This has led us to tailor One Anastomosis Gastric Bypass (BAGUA to achieve better results in this group of patients. Patients and Methods: We studied 83 (37 diabetic and 46 nondiabetic BMI 30 and up patients who completed all evaluation appointment (preoperative, 10 days, 1, 3, 6 and 12 months after tailored BAGUA for diabesity. We used the Tanita body composition analyzer BC-420 MA by the method of single frequency impedance to analyze the evolution of BC in patients classified by BMI 30 - 34,9, 35 - 50, and >50. Results: While preoperative excess weight presented dramatic decreases after tailored BAGUA in all the groups, super obese have different final BC. Diabetics retained more fat mass and visceral fat, where super obese have double (14 kg that simple obese patients (6 kg, they lost more muscle mass, and have higher basal metabolism. The final BC is altered in all parameters if diabetes is added. Conclusions: The reduction of the preoperative excess weight is motivated largely by the tailored effect of BAGUA. Patients BMI 30-50 behaved homogeneous in BC after surgery while patients BMI >50 behave different. Super obese lose less weight, retained more fat mass, visceral fat, bone mass, and total water. This effect should be treated by more aggressive surgery by measuring the entire small intestine to make a proper exclusion (tailored to achieve homogeneous effects.

  8. Peripheral, but not central, GLP-1 receptor signaling is required for improvement in glucose tolerance after Roux-en-Y gastric bypass in mice.

    Science.gov (United States)

    Carmody, Jill S; Muñoz, Rodrigo; Yin, Huali; Kaplan, Lee M

    2016-05-15

    Roux-en-Y gastric bypass (RYGB) causes profound weight loss and remission of diabetes by influencing metabolic physiology, yet the mechanisms behind these clinical improvements remain undefined. After RYGB, levels of glucagon-like peptide-1 (GLP-1), a hormone that enhances insulin secretion and promotes satiation, are substantially elevated. Because GLP-1 signals in both the periphery and the brain to influence energy balance and glucose regulation, we aimed to determine the relative requirements of these systems to weight loss and improved glucose tolerance following RYGB surgery in mice. By pharmacologically blocking peripheral or central GLP-1R signaling, we examined whether GLP-1 action is necessary for the metabolic improvements observed after RYGB. Diet-induced obese mice underwent RYGB or sham operation and were implanted with osmotic pumps delivering the GLP-1R antagonist exendin-(9-39) (2 pmol·kg(-1)·min(-1) peripherally; 0.5 pmol·kg(-1)·min(-1) centrally) for up to 10 wk. Blockade of peripheral GLP-1R signaling partially reversed the improvement in glucose tolerance after RYGB. In contrast, fasting glucose and insulin sensitivity, as well as body weight, were unaffected by GLP-1R antagonism. Central GLP-1R signaling did not appear to be required for any of the metabolic improvements seen after this operation. Collectively, these results suggest a detectable but only modest role for GLP-1 in mediating the effects of RYGB and that this role is limited to its well-described action on glucose regulation. PMID:27026085

  9. Nonalcoholic fatty liver disease in Japanese patients with severe obesity who received laparoscopic Roux-en-Y gastric bypass surgery (LRYGB) in comparison to non-Japanese patients

    International Nuclear Information System (INIS)

    The number of patients with morbid obesity is increasing worldwide. However, the prevalence of morbid obesity is still low in Japan, and therefore few systematic investigations of liver dysfunction in this population have so far been carried out. This study aimed to investigate the clinical characteristics in severe obese Japanese patients undergoing laparoscopic Roux-en-Y gastric bypass surgery (LRYGB). Eighty-four patients with severe obesity, including 61 Japanese and 23 non-Japanese patients, were analyzed. The mean body mass index (BMI) was 43.7±7.8 kg/m2, and there was no difference between Japanese and non-Japanese patients. Nonalcoholic fatty liver disease (NAFLD) was observed in 45/59 (76.2%) of the Japanese patients. Although there were no differences in the BMI and body weight, serum alanine aminotransferase (ALT) was higher in Japanese patients in comparison to non-Japanese patients (P<0.05). The indices for insulin resistance were significantly higher in the Japanese patients in comparison to non-Japanese patients (P<0.01). The liver/spleen computed tomography (CT) ratios were lower in Japanese patients (P<0.05). The laboratory data and BMI significantly improved at 1 year after LRYGB in both groups. Racial difference may exist difference may exist in NAFLD in patients with severe obesity. When the BMI is similar, liver dysfunction among Japanese patients with severe obesity tends to be higher than in non-Japanese patients. Japanese patients with severe obesity must therefore reduce their body weight to a greater degree in comparison to non-Japanese patients with the same BMI. LRYGB can achieve effective weight control and lower ALT levels in Japanese patients with severe obesity. (author)

  10. Gastric bypass in morbid obese patients is associated with reduction in adipose tissue inflammation via N-oleoylethanolamide (OEA)-mediated pathways.

    Science.gov (United States)

    Montecucco, Fabrizio; Lenglet, Sébastien; Quercioli, Alessandra; Burger, Fabienne; Thomas, Aurélien; Lauer, Estelle; da Silva, Analina Raquel; Mach, François; Vuilleumier, Nicolas; Bobbioni-Harsch, Elisabetta; Golay, Alain; Schindler, Thomas H; Pataky, Zoltan

    2015-04-01

    Paradoxically, morbid obesity was suggested to protect from cardiovascular co-morbidities as compared to overweight/obese patients. We hypothesise that this paradox could be inferred to modulation of the "endocannabinoid" system on systemic and subcutaneous adipose tissue (SAT) inflammation. We designed a translational project including clinical and in vitro studies at Geneva University Hospital. Morbid obese subjects (n=11) were submitted to gastric bypass surgery (GBS) and followed up for one year (post-GBS). Insulin resistance and circulating and SAT levels of endocannabinoids, adipocytokines and CC chemokines were assessed pre- and post-GBS and compared to a control group of normal and overweight subjects (CTL) (n=20). In vitro cultures with 3T3-L1 adipocytes were used to validate findings from clinical results. Morbid obese subjects had baseline lower insulin sensitivity and higher hs-CRP, leptin, CCL5 and anandamide (AEA) levels as compared to CTL. GBS induced a massive weight and fat mass loss, improved insulin sensitivity and lipid profile, decreased C-reactive protein, leptin, and CCL2 levels. In SAT, increased expression of resistin, CCL2, CCL5 and tumour necrosis factor and reduced MGLL were shown in morbid obese patients pre-GBS when compared to CTL. GBS increased all endocannabinoids and reduced adipocytokines and CC chemokines. In morbid obese SAT, inverse correlations independent of body mass index were shown between palmitoylethanolamide (PEA) and N-oleoylethanolamide (OEA) levels and inflammatory molecules. In vitro, OEA inhibited CCL2 secretion from adipocytes via ERK1/2 activation. In conclusion, GBS was associated with relevant clinical, metabolic and inflammatory improvements, increasing endocannabinoid levels in SAT. OEA directly reduced CCL2 secretion via ERK1/2 activation in adipocytes. PMID:25413674

  11. Quality assessment and anti-obesity activity of Stellaria media (Linn.) Vill

    Science.gov (United States)

    2012-01-01

    Background Obesity is recognized as a social problem, associated with serious health risks and increased mortality. Numerous trials have been conducted to find and develop new anti-obesity drugs through herbal sources to minimize side effects associated with the present anti-obesity drugs. The present study was designed to evaluate the quality control parameters, quantitative phytochemical analysis (total phenolic, total flavonoids and total saponin content), and the anti-obesity effect of lyophilized juice (LJ) of Stellaria media (Linn.) Vill. by employing in vitro and in vivo models. Methods In vitro studies were performed to evaluate the inhibitory activity of LJ on pancreatic amylase and lipase. The in vivo pancreatic lipase activity was evaluated by measurement of plasma triacylglycerol levels after oral administration of lipid emulsion to swiss albino mice. Furthermore, the anti-obesity effect of LJ was assessed at two doses, 400 mg/kg and 900 mg/kg body weight in mice fed a high-fat-diet with or without LJ for 6 weeks. Results The LJ inhibited pancreatic amylase and lipase activity in vitro and elevated plasma triacylglycerol level in mice. LJ suppressed the increase in body weight, retroperitoneal adipose tissue, liver weights and serum parameters viz., total cholesterol, total triglyceride, LDL-cholesterol level at the dose of 900 mg/kg body weight of the mice fed with high fat diet. The total phenolic, flavonoid and saponin contents were found to be 0.26 mg/g, 1.4 mg/g and 1.19 μg/g respectively of LJ. Conclusion The anti-obesity effects of LJ in high-fat-diet fed mice may be partly mediated through delaying the intestinal absorption of dietary fat and carbohydrate by inhibiting digestive enzymes. PMID:22943464

  12. Quality assessment and anti-obesity activity of Stellaria media (Linn. Vill

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    Rani Neerja

    2012-09-01

    Full Text Available Abstract Background Obesity is recognized as a social problem, associated with serious health risks and increased mortality. Numerous trials have been conducted to find and develop new anti-obesity drugs through herbal sources to minimize side effects associated with the present anti-obesity drugs. The present study was designed to evaluate the quality control parameters, quantitative phytochemical analysis (total phenolic, total flavonoids and total saponin content, and the anti-obesity effect of lyophilized juice (LJ of Stellaria media (Linn. Vill. by employing in vitro and in vivo models. Methods In vitro studies were performed to evaluate the inhibitory activity of LJ on pancreatic amylase and lipase. The in vivo pancreatic lipase activity was evaluated by measurement of plasma triacylglycerol levels after oral administration of lipid emulsion to swiss albino mice. Furthermore, the anti-obesity effect of LJ was assessed at two doses, 400 mg/kg and 900 mg/kg body weight in mice fed a high-fat-diet with or without LJ for 6 weeks. Results The LJ inhibited pancreatic amylase and lipase activity in vitro and elevated plasma triacylglycerol level in mice. LJ suppressed the increase in body weight, retroperitoneal adipose tissue, liver weights and serum parameters viz., total cholesterol, total triglyceride, LDL-cholesterol level at the dose of 900 mg/kg body weight of the mice fed with high fat diet. The total phenolic, flavonoid and saponin contents were found to be 0.26 mg/g, 1.4 mg/g and 1.19 μg/g respectively of LJ. Conclusion The anti-obesity effects of LJ in high-fat-diet fed mice may be partly mediated through delaying the intestinal absorption of dietary fat and carbohydrate by inhibiting digestive enzymes.

  13. Preoperative determinants of outcomes of laparoscopic gastric bypass in the treatment of morbid obesity Determinantes preoperatorios de resultados del bypass gástrico laparoscópico en el tratamiento de la obesidad mórbida

    Directory of Open Access Journals (Sweden)

    E. García Díaz

    2011-08-01

    Full Text Available Introduction: Laparoscopic gastric bypass (LGBP is the predominant technique in surgical treatment of morbid obesity. Objectives: To evaluate the results of LGBP and measure the validity of some hypothetical variables as predictors of these outcomes. Methods: We carried out a historical cohort study which included 50 morbidly obese patients operated with LGBP. The results were assessed by the Bariatric Analysis and Reporting Outcome System (BAROS, which measures the following parameters: the percentage of excess weight loss (EWL, changes in co-morbidities, quality of life and complications. The independent variables were age, body mass index (BMI, sex, history of depression and presence of more than one cardiovascular risk factor (CVRF. Results: Following LGBP, 11% of the results was classified as excellent, 54% as very good, 25% as good and 9% as fair (median follow-up period: 17 months, 7-37. The best scores were found among younger patients. The EWL (mean: 55.4 ± 16.6% was higher in patients with lower BMI and with no more than one cardiovascular risk factor. We obtained rates of resolution of CVRF of 43.7 to 68.7%, complication rates Introducción: El bypass gástrico laparoscópico (BPGL es la técnica predominante en el tratamiento quirúrgico de la obesidad mórbida. Objetivos: Evaluar los resultados del BPGL y medir la capacidad de algunas variables como hipotéticas predictoras de estos resultados. Métodos: En un estudio de cohorte histórico se han incluido 50 obesos mórbidos intervenidos mediante BPGL, valorando los resultados según el sistema BAROS; este considera el porcentaje de sobrepeso perdido (PSP, evolución de comorbilidades, calidad de vida y complicaciones. Las variables independientes han sido la edad, índice de masa corporal (IMC, sexo, presencia o no de historia depresiva y de más de un factor de riesgo cardiovascular (FRCV. Resultados: La clasificación de los resultados del BPGL fue: 11% resultado excelente, 54

  14. Comparison of Virtual Nutri Plus® and Dietpro 5i® software systems for the assessment of nutrient intake before and after Roux-en-Y gastric bypass

    Directory of Open Access Journals (Sweden)

    Mariane Marques da Silva

    2014-11-01

    Full Text Available OBJECTIVES: The assessment of nutritional intake before and after bariatric surgery assists in identifying eating disorders, nutritional deficiencies and weight loss/maintenance. The 7-day record is the gold standard for such an assessment and is interpreted using specialized software. This study sought to compare the Virtual Nutri Plus® and Dietpro 5i® software systems in assessing nutrient intake in obese patients with type 2 diabetes mellitus who underwent a Roux-en-Y gastric bypass. METHODS: Nutritional intake was assessed in 10 obese women with type 2 diabetes mellitus before and 3 months after Roux-en-Y gastric bypass. The 7-day record was used to assess food intake and then, the Virtual Nutri Plus® and Dietpro 5i® software systems were used to calculate calorie, macronutrient and micronutrient intake based on validated food chemical composition databases. Clinicaltrials.gov: NCT01251016. RESULTS: During the preoperative period, deficits in the ingestion of total fiber and 15 out of 22 estimated micronutrients were observed when using the Virtual Nutri Plus®, compared to deficiencies in total fiber and 4 micronutrients when using the Dietpro 5i®. During the postoperative period, both the Virtual Nutri Plus® and Dietpro 5i® systems detected deficits in the ingestion of total fiber, carbohydrates and 19 micronutrients, but only the Virtual Nutri Plus® detected deficits in complex B vitamins (except B12 and minerals. CONCLUSION: Virtual Nutri Plus® was more sensitive than Dietpro 5i® for the identification of deficits in nutrient intake in obese, type 2 diabetes mellitus patients undergoing Roux-en-Y gastric bypass.

  15. Reduction in cardiovascular risk factors and insulin dose, but no beta-cell regeneration 1 year after Roux-en-Y gastric bypass in an obese patient with type 1 diabetes

    DEFF Research Database (Denmark)

    Dirksen, Carsten; Jacobsen, Siv H; Bojsen-Møller, Kirstine N; Jørgensen, Nils B; Naver, Lars S; Hvolris, Lisbeth E; Worm, Dorte; Madsbad, Sten; Holst, Jens Juul; Hansen, Dorte L

    2013-01-01

    Experience with Roux-en-Y gastric bypass in patients with type 1 diabetes is very limited, despite an increasing prevalence of obesity also in this population. We describe changes in anthropometric measures, insulin dose, HbA1c, blood pressure, lipid status, and metabolic response to a liquid mixed...... meal throughout the first year after RYGB in an obese patient with type 1 diabetes. No change in HbA1c was observed, but a 48% reduction in weight-adjusted insulin dose and improvements in cardiovascular risk factors was seen 1 year after surgery. Exaggerated secretions of anorexigenic gut hormones...

  16. Stenosis in laparoscopic gastric bypass: management by endoscopic dilation without fluoroscopic guidance Estenosis tras derivación gástrica laparoscópica: tratamiento mediante dilataciones endoscópicas sin control radiológico

    Directory of Open Access Journals (Sweden)

    Jesús Espinel

    2011-10-01

    Full Text Available Objectives: gastric bypass is the surgical procedure that is carried out most frequently in the treatment of morbid obesity. Stenosis of the gastro-jejunal anastomosis is a relatively frequent complication that requires endoscopic management. However, the optimal dilation technique is yet to be determined. The purpose of this study was to evaluate the safety and efficacy of dilation with a hydrostatic balloon (CRE without radioscopic guidance in morbidly obese patients treated by laparoscopic bypass. Material and methods: retrospective review of the data elicited from 525 patients treated against morbid obesity with laparoscopic gastric bypass from January, 2006 to November, 2010. Results: a total of 22/525 patients (4.1% developed stenosis of the anastomosis [20 women (91%, 2 men (9%]. In four patients (18.2%, there was an associated anastomotic ulcer, and in one case, there was a history of bleeding of an ulcer treated with sclerosis one month earlier. The diagnosis of stenosis was done in most patients during the first 90 days after the bypass. All cases were resolved by means of endoscopic dilation without radioscopic guidance, 15 cases (68.1% required a single session, 6 cases (27.2% two sessions, and 1 case (4.5% required four sessions. This last case had an associated anastomotic ulcer. The diameter of the balloons ranged from 12 to 20 mm, generally using diameters of 12-15 mm in the first session, and increasing them in the following sessions according to the previous result. One patient treated with a 20 mm balloon presented with a small tear, without showing any evidence of leak of contrast medium in the radioscopic guidance, and was thus managed conservatively. In the follow-up, no re-stenoses were detected. Conclusions: in our experience, stenosis of the anastomosis in the laparoscopic gastric bypass is an infrequent complication. When it happens, dilation with a hydrostatic balloon is an effective and safe treatment. Radioscopic

  17. Enhanced Anti-Obesity Activities of Red Mold Dioscorea When Fermented Using Deep Ocean Water as the Culture Water

    OpenAIRE

    Tzu-Ming Pan; Chun-Lin Lee; Jyh-Jye Wang; Tsung-Yu Tsai; Bai-Luh Wei; Yi-Hsin Kung; Tzu-Ying Lung; Li-Chun Wang

    2013-01-01

    Deep ocean water (DOW) has, in previous studies, been found to be a novel anti-obesity drink and useful in raising Monascus-produced monascin and ankaflavin levels. This may resolve the limited anti-obesity ability of red mold dioscorea (RMD) known as the Monascus purpureus-fermented Disocorea batatas. This study aims to compare the anti-obesity effect of DOW-cultured RMD (DOW-RMD) and ultra-pure water-cultured RMD (UPW-RMD) in rats fed on a high fat diet. Moreover, the effect of ions composi...

  18. Weighing the Options: Gastric Sleeve Surgery

    Medline Plus

    Full Text Available ... bariatrics over the past 10 years. Absolutely. The gold standard is the laparoscopic roux-en-y gastric ... as an alternative to the other two. The gold standard is the roux-en-y gastric bypass. ...

  19. Duodenum inclusion in alimentary transit for preventing or correcting nutritional deficiencies resulting from Roux-en-y gastric bypass in obesity treatment.

    Science.gov (United States)

    Ceneviva, Reginaldo

    2016-01-01

    Nutritional and metabolic complications can develop after Roux-en-Y gastric bypass (RYGB) when there is an exaggerated response to the anatomical and functional changes or when there is inadequate nutritional supplementation. Severe malnutrition is rare, but deficiencies of vitamin B12, iron, calcium and thiamin, metabolic bone disease and gallstones are common after RYGB. Shortage of vitamin B12, iron, calcium and also cholelithiasis are caused at least partially by excluding the duodenum and proximal jejunum from food transit. We designed a new procedure, with the maintenance of the duodenum and proximal jejunum in the gastrointestinal transit through interposition of jejunal loop, as a primary operation to prevent such deficiencies or as corrective surgery for severe malnutrition after RYGB with failure in responding to conservative treatment. Complicações nutricionais e metabólicas podem se desenvolver após a derivação gástrica em Y de Roux (DGYR) quando há uma resposta exagerada às mudanças anatômicas e funcionais ou quando há suplementação nutricional inadequada. A desnutrição grave é rara, mas deficiências de vitamina B12, ferro, cálcio e tiamina, doença óssea metabólica e cálculos biliares são comuns após a DGYR. Dessas deficiências mencionadas, a de vitamina B12, de ferro, de cálcio e também a colelitíase, são causadas, ao menos parcialmente, pela exclusão do duodeno e jejuno proximal. Um novo procedimento com a manutenção do duodeno e do jejuno proximal no trânsito gastrointestinal, mediante interposição de alça jejunal, foi idealizado como operação primária para prevenir essas deficiências ou como cirurgia corretiva de desnutrição grave após DGYR com falha na resposta a exaustivas tentativas de tratamento conservador. PMID:27275596

  20. Anti-Obesity Effects of Onion Extract in Zucker Diabetic Fatty Rats

    OpenAIRE

    Kiharu Igarashi; Yoshiaki Shiojima; Orie Yoshinari

    2012-01-01

    Anti-obesity effects of onion extract were determined in obesity and diabetes-prone Zucker diabetic fatty rats by measuring the efficacy of markers concerned with diabetes and obesity. Body and adipose tissue weights in 5% of onion extract-fed group were found to be significantly lower than the control group without onion extract. Fasting blood glucose and HOMA-IR levels were also improved, although the serum insulin and leptin levels did not show any remarkable difference. Serum triglyceride...

  1. Review: Evidence-based Clinical Research of Anti-obesity Supplements in Japan

    OpenAIRE

    Yasueda, Asuka; Ito, Toshinori; MAEDA, KAZUHISA

    2013-01-01

    Background: The prevalence of obesity has increased dramatically throughout the world, and weight reduction through lifestyle management is urgently warranted. At present, numerous supplements advertised for their anti-overweight property are available in the Japanese market, but most of these lack proper evidence. Thus, we investigated dietary supplements that have been tested in clinical trials. Search Strategy: We researched anti-obesity supplements in the Japanese market using the google ...

  2. Attitudes and Reported Practice for Obesity Management in Korea After Introduction of Anti-obesity Agents

    OpenAIRE

    Park, Hye Soon; Park, Jee-Young; Cho, Hong-Jun

    2005-01-01

    This study aimed to evaluate current clinical assessments and management of obesity in the primary care setting in Korea since anti-obesity agents have become available. A questionnaire was sent to eligible primary care physicians selected from a national probability sample in two specialties: family physicians and internists. Of 939 randomly selected physicians, 452 (48.1%) replied. We found that 51.8% of physicians were aware of the definition of obesity, and 33.8% were aware of the definit...

  3. Phlegmonous Gastritis Following Coronary Bypass Surgery

    OpenAIRE

    Radhi, J; Kamouna, M; Nyssen, J.

    1999-01-01

    Phlegmonous gastritis is a rare, rapidly progressive and potentially fatal gastric bacterial infection. A case of phlegmonous gastritis following a coronary bypass surgery is described. This condition was not diagnosed premortem due to the nonspecific nature of the gastrointestinal symptoms. Upper gastrointestinal endoscopy may be of value in establishing the diagnosis in emergencies with culture of gastric aspirate and biopsy.

  4. Valoración diagnóstica y psicopatológica del trastorno por atracón en obesos mórbidos intervenidos de bypass gástrico Diagnostic and psychopathologic evaluation of binge eating disorder in gastric bypass patients

    Directory of Open Access Journals (Sweden)

    E. García Díaz

    2012-04-01

    Full Text Available Introducción: La presencia de trastorno por atracón (TA podría influir en los resultados del bypass gástrico laparoscópico (BPGL en el tratamiento de la obesidad mórbida. En población anglosajona, el TA suele valorarse mediante los cuestionarios Eating Disorder Examination-Questionnaire (EDE-Q y Questionnaire on Eating and Weight Patterns-Revised (QEWP-R. Objetivos: Estudiar la validez y concordancia del EDEQ y QEWP-R para el diagnóstico y valoración psicopatológica del TA en población española con obesidad mórbida intervenida mediante BPGL. Métodos: En un estudio transversal se le ha solicitado a 27 obesos mórbidos recién intervenidos mediante BPGL que cumplimentaran el EDE-Q y QEWP-R traducidos al español. Según las respuestas se han identificado los pacientes con y sin TA, evaluando posibles diferencias entre estos grupos en los ítems con interés psicométrico y midiendo la concordancia entre ambos cuestionarios. Resultados: El QEWP-R permitió diagnosticar un 25,9% de TA y el EDE-Q un 18,5%. Los pacientes con TA tuvieron mayores puntuaciones en los ítems sobre la importancia del peso o figura en la autovaloración, la interferencia en la capacidad de concentración por pensar en la comida, silueta o peso y la frecuencia del sentimiento de culpa después de comer. Entre ambos cuestionarios la concordancia diagnóstica fue escasa, pero se encontró una asociación fuerte entre los ítems con interés psicométrico. Conclusiones: El TA es frecuente en obesos mórbidos intervenidos mediante BPGL y forma un subgrupo de pacientes con más alteraciones psicopatológicas. El QEWP-R y el EDE-Q en español son cuestionarios adecuados para su valoración.Introduction: The presence of binge eating disorder (BED can influence the outcomes of laparoscopic gastric bypass (BPGL in the treatment of morbid obesity. In English population, BED is assessed usually through the Eating Disorder Examination-Questionnaire (EDE-Q and Questionnaire

  5. Banda gástrica com desvio jejunoileal: nova opção técnica em cirurgia bariátrica Gastric band with jejunoileal by-pass: new option in bariatric surgery

    Directory of Open Access Journals (Sweden)

    Bruno Zilberstein

    2010-06-01

    Full Text Available RACIONAL: Os procedimentos cirúrgicos para tratamento da obesidade morbida têm sido eficientes na resolução desta afecção a curto e longo prazo. Com exceção da banda gástrica ajustável todos estes procedimentos de alguma forma são capazes de induzir a liberação de hormônios intestinais em função do desvio intestinal e desta forma exercerem um efeito metabólico. OBJETIVO: Com a intenção de obter efeitos semelhantes às operações que promovem um desvio intestinal, com as vantagens de baixa morbidade e mortalidade da BGA, foi proposto novo procedimento técnico associando à banda gástrica ajustável a um desvio jejunoileal. MÉTODO: O procedimento cirúrgico totalmente conduzido por videolaparoscopia, consiste na aplicação inicial da banda gástrica e a seguir a realização de anastomose látero-lateral a 80 cm do ângulo duodenojejunal e 120 cm da válvula ileocecal. RESULTADOS: Foram operados 10 pacientes com esta técnica, seis mulheres e quatro homens com IMC médio de 40 kg/m². A perda média de excesso de peso nos seis primeiros meses foi de 51,56%. Em quatro pacientes diabéticos houve normalização dos níveis glicêmicos e suspensão do uso da medicação antidiabética. CONCLUSÃO: Adição de desvio jejunoileal látero-lateral à banda gástrica pode melhorar a perda de peso em pacientes portadores de obesidade mórbida e contribuir para o controle da diabete tipo II.BACKGROUND: Current procedures for surgical treatment of morbid obesity have proved to be efficient in controlling the process in the short and long follow-up. The bariatric surgical procedures, with the exception of the adjustable gastric banding are capable, in one way or another, of inducing hormonal release due to the intestinal by-pass that they may promote and therefore offering a metabolic effect. AIM: With the intention to maintain the same results promoted by gastrojejunal diversion, while maintaining the lower mortality rates of the

  6. Optimization of the Preparation of Fish Protein Anti-Obesity Hydrolysates Using Response Surface Methodology

    Directory of Open Access Journals (Sweden)

    Jinju Wang

    2013-02-01

    Full Text Available The enzymatic condition for producing the anti-obesity hydrolysates from fish water-soluble protein was optimized with the aid of response surface methodology, which also derived a statistical model for experimental validation. Compared with neutral protease, papain and protamex, the porcine pancreas lipase inhibitory rate of hydrolysates from fish water-soluble protein was higher with alkaline protease. Results showed that the model terms were significant, the terms of lack of fit were not significant, and the optimal conditions for the hydrolysis by alkaline protease were initial pH 11, temperature 39 °C, enzyme dosage 122 U/mL and 10 h of hydrolysis time. Under these conditions, the porcine pancreas lipase and the α-amylase inhibitory rate could reach 53.04% ± 1.32% and 20.03 ± 0.89%, while predicted value were 54.63% ± 1.75%, 21.22% ± 0.70%, respectively. In addition, Lineweaver-Burk plots showed noncompetitive inhibition. The Ki value calculated was 84.13 mg/mL. These results demonstrated that fish water-soluble protein could be used for obtaining anti-obesity hydrolysates.

  7. Anti-Obesity Effects of Onion Extract in Zucker Diabetic Fatty Rats

    Directory of Open Access Journals (Sweden)

    Kiharu Igarashi

    2012-10-01

    Full Text Available Anti-obesity effects of onion extract were determined in obesity and diabetes-prone Zucker diabetic fatty rats by measuring the efficacy of markers concerned with diabetes and obesity. Body and adipose tissue weights in 5% of onion extract-fed group were found to be significantly lower than the control group without onion extract. Fasting blood glucose and HOMA-IR levels were also improved, although the serum insulin and leptin levels did not show any remarkable difference. Serum triglyceride and free fatty acid levels in both the 3% and 5%-fed group were found to be reduced compared to the control group. Additionally the feeding of the onion extract increased the glucose tolerance. These results suggest that dietary onion extract is beneficial for improving diabetes by decreasing lipid levels. We also examined differentiation ability of rat white preadipocyte cells using the onion extract and its sulfur-containing components. Cycloalliin, S-methyl-l-cysteine, S-propyl-l-cysteine sulfoxide, dimethyl trisulfide, especially S-methyl-l-cysteine sulfoxide were reported to be effective in inhibiting formation of oil drop in the cells, suggesting that these compounds may be involved in the anti-obesity effect of the onion extract.

  8. Anti-obesity effect of resveratrol-amplified grape skin extracts on 3T3-L1 adipocytes differentiation

    OpenAIRE

    Zhang, Xian-Hua; Huang, Bo; Choi, Soo-Kyong; Seo, Jung-Sook

    2012-01-01

    Resveratrol (3,4,5-trihydroxy-trans-stilbene), a phytoalexin found in grape skin, grape products, and peanuts as well as red wine, has been reported to have various biological and pharmacological properties. The purpose of this study was to investigate the anti-obesity effect of resveratrol-amplified grape skin extracts on adipocytes. The anti-obesity effects of grape skin extracts were investigated by measuring proliferation and differentiation in 3T3-L1 cells. The effect of grape skin ethan...

  9. Enhanced Anti-Obesity Activities of Red Mold Dioscorea When Fermented Using Deep Ocean Water as the Culture Water

    Directory of Open Access Journals (Sweden)

    Tzu-Ming Pan

    2013-10-01

    Full Text Available Deep ocean water (DOW has, in previous studies, been found to be a novel anti-obesity drink and useful in raising Monascus-produced monascin and ankaflavin levels. This may resolve the limited anti-obesity ability of red mold dioscorea (RMD known as the Monascus purpureus-fermented Disocorea batatas. This study aims to compare the anti-obesity effect of DOW-cultured RMD (DOW-RMD and ultra-pure water-cultured RMD (UPW-RMD in rats fed on a high fat diet. Moreover, the effect of ions composition of DOW and DOW-influenced functional metabolites change of RMD on the differentiation and lipogenesis regulation were investigated using 3T3-L1 pre-adipocytes. In the animal test, compared to UPW-RMD, DOW-RMD possessed better ability to inhibit increases in weight gain, and better feed efficiency, body-fat pad and cross-sectional area of adipocytes. In the cell test, the anti-obesity abilities of DOW-RMD in inhibiting PPARγ and C/EBPα expression in differentiation and lipoprotein lipase activity in lipogenesis were contributed to by the DOW-increased monascin and ankaflavin levels and the ions of DOW, respectively.

  10. Anti-obesity effect of Dioscorea nipponica Makino with lipase-inhibitory activity in rodents.

    Science.gov (United States)

    Kwon, Chong-Suk; Sohn, Ho Yong; Kim, Sung Hee; Kim, Ji Hyun; Son, Kun Ho; Lee, Jeong Soon; Lim, Jin Kyu; Kim, Jong-Sang

    2003-07-01

    In the process of screening for pancreatic lipase inhibitors, which could be used as an anti-obesity measure, the methanol extract of Dioscorea nipponica Makino powder (DP) appeared to have potent inhibitory activity against porcine pancreatic lipase with an IC50 value of 5-10 microg/ml, where the enzyme activity was assayed by using 4-methylumbelliferyl oleate as a substrate. Further purification of active components present in the herb generated dioscin that belongs to the saponin family. Dioscin and its aglycone, diosgenin, both suppressed the time-dependent increase of blood triacylglycerol level when orally injected with corn oil to mice, suggesting their inhibitory potential against fat absorption. Sprague-Dawley rats fed on a high-fat diet containing 5% Dioscorea nipponica Makino and 40% beef tallow gained significantly less body weight and adipose tissue than control animals fed on a high-fat diet alone during an 8-week experimental period (P<0.05). PMID:12913286

  11. Anti-obesity and cardioprotective effects of cinnamic acid in high fat diet- induced obese rats.

    Science.gov (United States)

    Mnafgui, Kais; Derbali, Amal; Sayadi, Sami; Gharsallah, Neji; Elfeki, Abdelfattah; Allouche, Noureddine

    2015-07-01

    Obesity is a chronic metabolic disorder that is associated with numerous diseases including hyperlipidemia, diabetes mellitus, hypertension, atherosclerosis, cardiovascular disease, and cancer. Cinnamic acid is a phytochemical compound having many biological effects and could be considered for the management of obesity. This study is aimed to assess the possible anti-obesity and cardioprotective properties of cinnamic acid (CA) in high fat diet-fed rats (HFD). Male Wistar rats were divided into 4 groups. They received normal diet, HFD diet, HFD supplemented with fluvastatin (2 mg/kg/day) or cinnamic acid (30 mg/kg/day) for 7 weeks. The results showed an increase in body weight of HFD rats by ~27 % as compared to control group. Moreover, serum lipase activity underwent a significant rise by 103 % which led to an increase in the levels of total cholesterol (T-Ch), triglycerides (TG), LDL-cholesterol in serum of untreated HFD-fed rats. Furthermore, the concentration of leptin and angiotensin-converting enzyme (ACE) activity exhibited remarkable increases in serum of HFD-fed rats as compared to controls. Whereas, the administration of CA to HFD-fed rats improved the body weight gain and serum lipid profile and reverted back near to normal the activities of lipase and ACE. In addition, the echocardiography evidenced that CA is able to protect the aorta and aortic arch and avoided vasoconstriction by increasing their diameters and improved liver steatosis and kidney indices of toxicity. Overall, these results suggest that cinnamic acid exerts anti-obesity and antihypertensive effects through inhibition of lipid digestive enzymes and ACE. PMID:26139902

  12. Endoscopic and ultrasonographic evaluation before and after Roux-en-Y gastric bypass for morbid obesity Avaliação endoscópica e ultra-sonográfica antes e depois de gastroplastia com derivação intestinal em Y-de-Roux para obesidade mórbida

    OpenAIRE

    Marcelo Passos Teivelis; Joel Faintuch; Robson Ishida; Paulo Sakai; Adriano Bresser; Joaquim Gama-Rodrigues

    2007-01-01

    BACKGROUND: Esophagogastric abnormalities are recognized prior and after bariatric procedures, but frequency and severity are debated. Liver and biliary tract findings are also of clinical importance, especially gallstones and liver steatosis. AIM: To compare pre-operative findings of hepatobiliary ultrasound and upper digestive endoscopy with post-operative results in patients submitted to open Roux-en-Y gastric bypass for morbid obesity. METHODS: A total of 80 patients were enrolled 16.8 &p...

  13. Effects of Roux-en-Y gastric bypass on fasting and postprandial inflammation-related parameters in obese subjects with normal glucose tolerance and in obese subjects with type 2 diabetes

    DEFF Research Database (Denmark)

    Bovbjerg, Kirsten Katrine Lindegaard; Jorgensen, Nils Bruun; Just, Rasmus; Heegaard, Peter M. H.; Madsbad, Sten

    2015-01-01

    explored the hypothesis that Roux-en-Y gastric bypass (RYGB) reduces circulating levels of pro-inflammatory cytokines, while increasing anti-inflammatory cytokines in obese subjects with type 2 diabetes (T2D) and in obese normal glucose tolerant (NGT) subjects. Methods: Thirteen obese subjects with T2D...... [weight; 129 +/- 14 kg, glycated hemoglobin (HbA1c); 7.0 +/- 0.9%, body mass index (BMI); 43.2 +/- 5.3 kg/m(2), mean +/- SD] and twelve matched obese NGT subjects [weight; 127 +/- 15 kg, HbA1c; 5.5 +/- 0.4%, BMI; 41.5 +/- 4.8 kg/m(2), mean +/- SD] were examined before, one week, three months, and one year...... between the two groups. Before surgery, HbA1c was higher and HOMA-IR lower in T2D patients, however, converged to the values of NGT subjects one year after surgery. Circulating cytokine concentrations did not differ between the two groups at any time point. One week after surgery, circulating IL-6 and IL...

  14. Gastric blow-out: komplikation efter fedmekirurgi

    DEFF Research Database (Denmark)

    Torrens, Ayoe Sabrina; Born, Pernille Wolder; Naver, Lars

    2009-01-01

    Laparoscopic gastric bypass is the most common type of surgery for morbid obesity in Denmark. The most frequent late complications after gastric bypass are ulcer, internal hernia and stenosis. Two cases of stenosis of the bileopancreatic limb with gastric blow-out are described. Urgent diagnosis...... with computed tomography and acute surgical treatment is vital as the complication can lead to gastric necrosis, pancreatitis, biliary stasis, sepsis and multi-organ failure within a very short time. Prompt contact to specialized surgeons is advocated. Udgivelsesdato: 2009-Nov...

  15. Comparison of results from different imputation techniques for missing data from an anti-obesity drug trial

    DEFF Research Database (Denmark)

    Jørgensen, Anders W.; Lundstrøm, Lars H; Wetterslev, Jørn;

    2014-01-01

    BACKGROUND: In randomised trials of medical interventions, the most reliable analysis follows the intention-to-treat (ITT) principle. However, the ITT analysis requires that missing outcome data have to be imputed. Different imputation techniques may give different results and some may lead to bias....... In anti-obesity drug trials, many data are usually missing, and the most used imputation method is last observation carried forward (LOCF). LOCF is generally considered conservative, but there are more reliable methods such as multiple imputation (MI). OBJECTIVES: To compare four different methods of...... handling missing data in a 60-week placebo controlled anti-obesity drug trial on topiramate. METHODS: We compared an analysis of complete cases with datasets where missing body weight measurements had been replaced using three different imputation methods: LOCF, baseline carried forward (BOCF) and MI...

  16. Weighing the Options: Gastric Sleeve Surgery

    Medline Plus

    Full Text Available ... can always make the hole bigger. With enough force - - (laughing). It’s going to come out one way ... y gastric bypass, you lose about three to five pounds a week, an average of about 70 ...

  17. Weighing the Options: Gastric Sleeve Surgery

    Medline Plus

    Full Text Available ... to this point. Basically, we see our corpulent model here, and Dr. Sebastien marked out place right ... classic gastric bypass. And, here is our corpulent model again. We’ve made the incisions, we are ...

  18. Weighing the Options: Gastric Sleeve Surgery

    Medline Plus

    Full Text Available ... everyone else on board as a team, as far as the medical doctor, the nutritionist, the exercise ... en-y gastric bypass and the band as far as the amount of weight you can lose ...

  19. Weighing the Options: Gastric Sleeve Surgery

    Medline Plus

    Full Text Available ... on the screen right now. You are a shell of your former self. I don’t recognize ... of them, and it really depends on the companies. Some insurances will cover the gastric bypass and ...

  20. Weighing the Options: Gastric Sleeve Surgery

    Medline Plus

    Full Text Available ... the roux-en-y gastric bypass is the malnutrition. The patients who undergo that procedure must take ... and they have to be monitored periodically for deficits in vitamins and minerals because of the absorption ...

  1. Weighing the Options: Gastric Sleeve Surgery

    Medline Plus

    Full Text Available ... of them, and it really depends on the companies. Some insurances will cover the gastric bypass and ... is the band, called the realized band, another product of J&J and Ethicon, correct? Same people ...

  2. Weighing the Options: Gastric Sleeve Surgery

    Medline Plus

    Full Text Available ... the roux-en-y gastric bypass is the malnutrition. The patients who undergo that procedure must take ... within reason, and not have to worry about malnutrition. Well, essentially, everyone will be able to eat ...

  3. Anti ­ diabetic and anti-obesity effects of plant extract from Cleome droserifolia (SAMWA

    Directory of Open Access Journals (Sweden)

    Eman G. E. Helal, **Hafiza A. Sharaf and ***Fathy E. Mattar

    2002-12-01

    Full Text Available In this work the mechanism of the hypoglycemic effect of an aqueous extract from Cleome droserifolia (SAMWA was studied in a group of glucose intolerant senile rats and compared with normal senile control rats. The plant extract significantly suppressed the rise in blood glucose concentration. The hypoglycemic effect of the plant extract without increasing insulin secretion was explained by: 1 potentiation of peripheral and hepatic insulin sensitivity, 2 by diminishing intestinal glucose absorption, which was evident by blunting plasma glucose levels throughout the oral glucose challenge. This was accompanied by a significant decrease of liver glycogen content and a highly significant increase in leptin concentration which may suggest an anti-obesity role for the plant extracts. Plant extracts also decreased serum urea nitrogen. No changes on liver or heart function were observed. In histological sections of liver and kidney minor changes were noticed. These extracts might prove to have a promising therapeutic value in the treatment of diabetes mellitus. Besides its suppression to hepatic glucose output, SAMWA beneficial therapeutic finding in favor of the plant as a replacement for insulin which is the most important drug that brings bout this effect.

  4. A Review of Potential Marine-derived Hypotensive and Anti-obesity Peptides.

    Science.gov (United States)

    Manikkam, V; Vasiljevic, T; Donkor, O N; Mathai, M L

    2016-01-01

    Bioactive peptides are food derived components, usually consisting of 3-20 amino acids, which are inactive when incorporated within their parent protein. Once liberated by enzymatic or chemical hydrolysis, during food processing and gastrointestinal transit, they can potentially provide an array of health benefits to the human body. Owing to an unprecedented increase in the worldwide incidence of obesity and hypertension, medical researchers are focusing on the hypotensive and anti-obesity properties of nutritionally derived bioactive peptides. The role of the renin-angiotensin system has long been established in the aetiology of metabolic diseases and hypertension. Targeting the renin-angiotensin system by inhibiting the activity of angiotensin-converting enzyme (ACE) and preventing the formation of angiotensin II can be a potential therapeutic approach to the treatment of hypertension and obesity. Fish-derived proteins and peptides can potentially be excellent sources of bioactive components, mainly as a source of ACE inhibitors. However, increased use of marine sources, poses an unsustainable burden on particular fish stocks, so, the underutilized fish species and by-products can be exploited for this purpose. This paper provides an overview of the techniques involved in the production, isolation, purification, and characterization of bioactive peptides from marine sources, as well as the evaluation of the ACE inhibitory (ACE-I) activity and bioavailability. PMID:25569557

  5. Anti-obesity and anti-diabetic actions of histamine neurons

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    The present study aimed to examine roles of histamine neurons in leptin signaling pathways and leptin resistant states. H1-receptor knockout (H1KO) mice showed no change in daily food intake, adiposity, growth curve, basal expression of hypothalamic neuropeptides, uncoupling proteins (UCPs) or ob gene. However, H1KO mice fed with high fat diet increased fat deposition and ob gene expression more excessively. Leptin-induced feeding suppression was attenuated in H1KO mice. Chronic leptin treatment decreased visceral fat and up-regulated UCPs expression in brown and white fat. These effects of leptin were attenuated in pair-fed H1KO mice. Chronic histamine or histidine treatment decreased body weight, body fat deposition, and serum glucose and insulin in diet-induced obese, ob/ob and db/db mice. Activation of histamine neurons suppressed ob gene expression in the fat tissue together with elevation of seurm leptin and UCPs mRNA. These actions of neuronal histamine were attenuated in the double knockout mice, i.e., db/db mice with H1KO. Taken together, H1KO mice, a novel leptin resistant model, elucidate essential roles of H1-R in energy intake and expenditure as a down-stream-signaling message of leptin actions in the brain. The anti-obesity and anti-diabetic effects of histamine neurons provide a new insight into therapeutic strategies on human obesity and diabetes with leptin resistance.

  6. Molecular Mechanisms of the Anti-Obesity and Anti-Diabetic Properties of Flavonoids

    Directory of Open Access Journals (Sweden)

    Mohammed Kawser Hossain

    2016-04-01

    Full Text Available Obesity and diabetes are the most prevailing health concerns worldwide and their incidence is increasing at a high rate, resulting in enormous social costs. Obesity is a complex disease commonly accompanied by insulin resistance and increases in oxidative stress and inflammatory marker expression, leading to augmented fat mass in the body. Diabetes mellitus (DM is a metabolic disorder characterized by the destruction of pancreatic β cells or diminished insulin secretion and action insulin. Obesity causes the development of metabolic disorders such as DM, hypertension, cardiovascular diseases, and inflammation-based pathologies. Flavonoids are the secondary metabolites of plants and have 15-carbon skeleton structures containing two phenyl rings and a heterocyclic ring. More than 5000 naturally occurring flavonoids have been reported from various plants and have been found to possess many beneficial effects with advantages over chemical treatments. A number of studies have demonstrated the potential health benefits of natural flavonoids in treating obesity and DM, and show increased bioavailability and action on multiple molecular targets. This review summarizes the current progress in our understanding of the anti-obesity and anti-diabetic potential of natural flavonoids and their molecular mechanisms for preventing and/or treating obesity and diabetes.

  7. The anti-obesity drug orlistat reveals anti-viral activity.

    Science.gov (United States)

    Ammer, Elisabeth; Nietzsche, Sandor; Rien, Christian; Kühnl, Alexander; Mader, Theresa; Heller, Regine; Sauerbrei, Andreas; Henke, Andreas

    2015-12-01

    The administration of drugs to inhibit metabolic pathways not only reduces the risk of obesity-induced diseases in humans but may also hamper the replication of different viral pathogens. In order to investigate the value of the US Food and Drug Administration-approved anti-obesity drug orlistat in view of its anti-viral activity against different human-pathogenic viruses, several anti-viral studies, electron microscopy analyses as well as fatty acid uptake experiments were performed. The results indicate that administrations of non-cytotoxic concentrations of orlistat reduced the replication of coxsackievirus B3 (CVB3) in different cell types significantly. Moreover, orlistat revealed cell protective effects and modified the formation of multi-layered structures in CVB3-infected cells, which are necessary for viral replication. Lowering fatty acid uptake from the extracellular environment by phloretin administrations had only marginal impact on CVB3 replication. Finally, orlistat reduced also the replication of varicella-zoster virus moderately but had no significant influence on the replication of influenza A viruses. The data support further experiments into the value of orlistat as an inhibitor of the fatty acid synthase to develop new anti-viral compounds, which are based on the modulation of cellular metabolic pathways. PMID:25680890

  8. Recent Progress in Anti-Obesity and Anti-Diabetes Effect of Berries.

    Science.gov (United States)

    Tsuda, Takanori

    2016-01-01

    Berries are rich in polyphenols such as anthocyanins. Various favorable functions of berries cannot be explained by their anti-oxidant properties, and thus, berries are now receiving great interest as food ingredients with "beyond antioxidant" functions. In this review, we discuss the potential health benefits of anthocyanin-rich berries, with a focus on prevention and treatment of obesity and diabetes. To better understand the physiological functionality of berries, the exact molecular mechanism of their anti-obesity and anti-diabetes effect should be clarified. Additionally, the relationship of metabolites and degradation products with health benefits derived from anthocyanins needs to be elucidated. The preventive effects of berries and anthocyanin-containing foods on the metabolic syndrome are not always supported by findings of interventional studies in humans, and thus further studies are necessary. Use of standardized diets and conditions by all research groups may address this problem. Berries are tasty foods that are easy to consume, and thus, investigating their health benefits is critical for health promotion and disease prevention. PMID:27058561

  9. Anti-obesity and antioxidant activity of dietary flavonoids from Dioscorea steriscus tubers

    Institute of Scientific and Technical Information of China (English)

    Pamhidzai Dzomba; Cexton Musekiwa

    2014-01-01

    Objective:To investigate antioxidant and anti-obesity activity of flavonoids extracted by solvent cold percolation and preparative thin liquid chromatography from Dioscorea steriscus tubers. Methods: 1-diphenyl-2-picrylhydrazyl (DPPH) antiradical activity was employed to investigate antioxidant activity while chromogenic method was used to determine alpha amylase inhibition activity and spectrophotometric methods using triolein as a substrate was used to investigate lipase activity. Results: Thin liquid chromatography profiling revealed eight different flavonoid types. Ethyl acetate extract yielded two types, Rf values 0.38 and 0.40;chloroform extract also yielded two types Rf values 0.06 and 0.51, while ethanol extract yielded four types with Rf values 0.16, 0.33, 0.65 and 0.96. All the extracted flavonoids exhibited antioxidant activity with ethanol extracts exhibiting the greatest antiradical activity. The order of enzyme inhibition capacity was ethyl acetate Conclusions: Results of the present study show that Dioscorea steriscus consists of bioactive compounds that can act as lipase and α-amylase inhibitors and therefore can be useful for the development of functional foods against obesity. It can also be used as a source of lead compounds for designing new ant-obesity therapeuticals.

  10. New ethanol extraction improves the anti-obesity effects of black tea.

    Science.gov (United States)

    Park, Bongju; Lee, Sangjin; Lee, Bonggyeong; Kim, Ingyum; Baek, Namjoon; Lee, Tae Ho; Lee, Seok-Yong; Son, Miwon; Park, Hyunsung

    2016-03-01

    Black tea has been reported to have anti-obesity effects in both rodents and humans. Gallic acid, an active component of black tea, decomposes quickly into pyrogallol in high-temperature solutions. This study introduced a new, aqueous ethanol extraction of black tea, which resulted in extracts with higher concentrations of gallic acid than conventional black tea extracts prepared by hot-water extraction or hot-ethanol extraction. We confirmed that, compared with the hot-water extract of black tea, the cold-ethanol extract of black tea (CE-BTE) had greater effects on reducing body weight and body fat, improving fatty liver, regulating blood glucose, and reducing blood cholesterol in the high-fat diet-induced obese mouse model. Nonetheless, although CE-BTE significantly reduced fat content, it did not reduce peroxisome proliferator-activated receptor (PPARγ) protein in epididymal fat tissue of HFD mice. We also showed that CE-BTE did not inhibit the function of PPARγ protein to drive adipogenesis of mouse 3T3-L1 preadipocytes. Considering that PPARγ is a master transcription factor not only for adipocyte differentiation, but also for adipose tissue function, such as glucose and lipid metabolism and insulin sensitivity, these results suggest that CE-BTE reduced fat mass and body weight without dampening fat cell homeostasis and insulin sensitivity. PMID:26604105

  11. Anti-obesity phenotypic screening looking to increase OBR cell surface expression.

    Science.gov (United States)

    Kim, Tae-Hee; Choi, Dong-Hwa; Vauthier, Virginie; Dam, Julie; Li, Xiaolan; Nam, Yeon-Ju; Ko, YoonAe; Kwon, Ho Jeong; Shin, Sang Hoon; Cechetto, Jonathan; Soloveva, Veronica; Jockers, Ralf

    2014-01-01

    The leptin receptor, OBR, is involved in the regulation of whole-body energy homeostasis. Most obese people are resistant to leptin and do not respond to the hormone. The prevention and reversal of leptin resistance is one of the major current goals of obesity research. We showed previously that increased OBR cell surface expression concomitantly increases cellular leptin signaling and prevents obesity development in mice. Improvement of OBR cell surface expression can thus be considered as an interesting anti-obesity therapeutic strategy. To identify compounds that increase the surface expression of OBR, we developed a cell-based, phenotypic assay to perform a high-content screen (HCS) against a library of 50,000 chemical compounds. We identified 67 compounds that increased OBR cell surface expression with AC50 values in the low micromolar range and no effect on total OBR expression and cellular toxicity. Compounds were classified into 16 chemical clusters, of which 4 potentiated leptin-promoted signaling through the JAK2/STAT3 pathway. In conclusion, development of a robust phenotypic screening approach resulted in the discovery of four new scaffolds that demonstrate the desired biological activity and could constitute an original therapeutic solution against obesity and associated disorders. PMID:23958651

  12. 胃旁路手术治疗2型糖尿病研究现状%The Research Status of Gastric Bypass Surgery for the Treatment of Type 2 Diabetes Mellitus

    Institute of Scientific and Technical Information of China (English)

    林允信

    2011-01-01

    糖尿病是严重威胁人类健康的代谢性疾病,全球发病率已呈逐年上升趋势.胃旁路手术(GBP)在用于治疗肥胖症时,发现该手术可以治疗2型糖尿病.这一成果受到全世界医学界的关注,为2型糖尿病彻底根治带来新的希望.欧美国家和我国都用这种方法治疗2型糖尿病患者,且疗效显著,无不良反应.改进GBP手术方式和探讨治疗2型糖尿病机制是今后研究的重点.%Diabetes mellitus is a serious metabolic disease threatening human health. The worldwide prevalence of diabetes has been already increasing year by year. Gastric bypass ( GBP ) for bariatric surgery can be used for the treatment for type 2 diabetes mellitus. This result draws the global medical attention as a new hope for the cure of type 2 diabetes mellitus. European and American countries and China have been using this modality to treat type 2 diabetes mellitus. The curative effect is remarkable, without any side effect.Further studies should be performed to improve GBP procedure and investigate the mechanisms of type 2 diabetes mellitus.

  13. 胃旁路术对血糖的影响及其机制%Influence of gastric bypass surgery on fasting blood-glucose in type 2 diabetic rats

    Institute of Scientific and Technical Information of China (English)

    史逸华; 郑志坚; 戴灵波; 宋军; 江玲雅

    2013-01-01

    Objective To investigate the influence of gastric bypass surgery on fasting blood- glucose (FBG) levels in type 2 diabetic rats. Methods Forty rates were randomly divided into 4 groups with 10 in each groups:type 2 diabetes mel itus were induced by injection of stretozotocin in DO and DC group, gastric bypass operation was performed in DO and NO groups and sham operation was performed in DC and NC groups. The FBG levels were determined before operation and 72h, 1, 4 and 8 weeks after operation. The tissue sections were HE- stained and examined histopathological y. Results There were no signif-icant differences in FBG levels before operation between DO and DC groups or between NO and NC groups (P>0.05). FBG levels in DO group gradual y declined after operation and were lower than those before operation (P0.05). The inter- group and intra- group differences of FPG levels in NO and NC groups were not statistical y sig-nificant(P>0.05). HE staining showed that there was regeneration of pancreas islets and the morphology was similar to the nor-mal in DO group at 8 weeks after operation. Conclusion Gastric bypass operation can reduce the FBG levels in type 2 diabetic rats, which is associated with the regeneration of pancreas islets.%目的研究胃旁路术(GBP)对糖尿病大鼠血糖的控制效果以及对胰岛细胞的影响。方法采用链脲佐菌素建立糖尿病SD大鼠模型(20只),随机分为糖尿病手术组(DO组)和糖尿病对照组(DC组),另取20只非糖尿病大鼠随机分为正常手术组(NO组)和正常对照组(NC组)。DO组和NO组大鼠行GBP,DC组和NC组大鼠行假手术,分别检测各组大鼠术前、术后72h,1、4和8周空腹血糖水平。术后8周,取胰腺组织行HE染色和免疫荧光检查,观察组织学变化。结果术前DO组与DC组以及NC组与NO组大鼠空腹血糖均无统计学差异(均P>0.05)。DO组大鼠术后空腹血糖进行性下降(均P<0.05

  14. Individualized Care of Laparoscopic Gastric Bypass Surgery in the Treatment of Type 2 Diabetes%腹腔镜胃转流术治疗2型糖尿病的个体化护理

    Institute of Scientific and Technical Information of China (English)

    曹牡华

    2015-01-01

    Objective:To research the clinical effect of individualized care model for type 2 diabetes patients receiving care during the treatment of laparoscopic gastric bypass.Method:80 patients with type 2 diabetes underwent laparoscopic gastric bypass surgery treatment in our hospital from February 2013 to February 2015 were selected and divided into the control group and the observation group according to the random number table method,40 cases in each group.The control group was given conventional diabetes care model,the observation group was given individualized nursing model.The treatment effect,satisfaction with care during treatment,the time of blood sugar levels return to normal after treatment,the total treatment time of type 2 diabetes and adverse reactions during treatment between the two groups were observed and compared.Result:The total effective rate of the observation group was 90.0%,which was significantly higher than 67.5%of the control group,the satisfaction with care during treatment of the observation group was 95.0%(38/40),which was significantly higher than 80.0%(32/40)of the control group,the time of blood sugar levels return to normal after treatment and the total treatment time of type 2 diabetes in the observation group were significantly shorter than those in the control group,the incidence of adverse reaction in the observation group was(2.5%)significantly lower than 20.0%in the control group,the differences were statistically significant(P<0.05).Conclusion:The clinical nursing effect of individualized care model for patients with type 2 diabetes during the treatment of laparoscopic gastric bypass is significant,is worthy of clinical popularization and application.%目的:研究应用个体化护理服务模式对2型糖尿病患者在接受腹腔镜胃转流术治疗期间实施护理的临床效果。方法:选择2013年2月-2015年2月在本院就诊的接受腹腔镜胃转流术治疗的2型糖尿病患者80例,按照随机数字表

  15. Exploiting anti-obesity mechanism of Clerodendrum phlomidis against two different models of rodents

    Directory of Open Access Journals (Sweden)

    Vijay R Chidrawar

    2011-01-01

    Full Text Available Roots of Clerodendrum phlomidis are used by the local people of Dibrugarh district of Assam state India as a dietary supplement for treating weight issues and are also mentioned in the traditional system of Indian medicine as a remedy for obesity. We examined the anti-obesity effect of Clerodendrum phlomidis (family Verbenaceae L. roots against cafeteria diet (CD and progesterone-induced obesity. In CD-induced model obesity was induced by feeding CD for 48-days and increase in body weight and fat storage was suppressed co-administration with methanolic extract of Clerodendrum phlomidis (MECP at 400 mg/kg. Blood analysis showed that the levels of triglyceride and cholesterol were significantly lowered by MECP administration and there is subsequent rise in HDL-cholesterol level. From this experiment, we demonstrated that MECP is effective in ameliorating the CD-induced hyperglycemia, hyperinsulimenia, dyslepidemia, increase in wet weight of white adipose tissue, and hypertrophy of fat cells. In drug induced obesity model hyperphagia was induced by progesterone (10 mg/kg s.c. for 28 days and was suppressed by co-administration with MECP in dose dependent manner. It is tempting to speculate that these protective effects shown by Clerodendrum phlomidis is by multiple mechanisms. MECP contains β-sitosterol in the abundant quantity because of the structural similarity it do the physical competition with natural sterols while absorption of food stuffs from GIT and moreover the crude saponin and flavonoid has been reported for it′s the appιtit suppressant property and hence reduces hyperphagia produced by progesterone. This is the first report demonstrating that Clerodendrum phlomidis is effective in ameliorating insulin resistance and visceral obesity induced by CD and Progesterone.

  16. Baseline of visceral fat area and decreased body weight correlate with improved pulmonary function after Roux-en-Y Gastric Bypass in Chinese obese patients with BMI 28–35 kg/m2 and Type 2 diabetes: a 6-month follow-up

    OpenAIRE

    Tu, Yinfang; Yu, Haoyong; Bao, Yuqian; Zhang, Pin; Di, Jianzhong; Han, Xiaodong; Jia, Weiping

    2015-01-01

    Background Associations between demographic data and pulmonary function have not been adequately examined in patients that underwent Roux-en-Y Gastric Bypass (RYGB). This study was designed to examine changes in body fat distribution and metabolic parameters after RYGB and whether these changes correlated with improved lung function. Methods A retrospective review of 32 ethnic Chinese with obesity with body mass index (BMI) 28–35 kg/m2 and type 2 diabetes (T2DM) was conducted, focusing on met...

  17. Variations in dietary intake after bypass surgery for obesity. Possible relation to development of fatty liver after jejunoileal bypass

    Energy Technology Data Exchange (ETDEWEB)

    Rogus, J.; Blumenthal, S.A.

    1981-01-01

    Consumption of nutrients and food energy was compared, with concomitant chemical and radiologic measurements of hepatic fat content, preoperatively and postoperatively in 25 patients who underwent gastric or jejunoileal bypass for obesity. Patients in the two operative groups ingested similar quantities of food before surgery. After surgery, caloric intake from all sources decreased in both groups but to a significantly greater extent in the gastric bypass patients. During the first six months postoperatively, the 13 gastric bypass patients showed no changes in hepatic fat content, whereas substantial increases in liver fat uniformly occurred in the 12 patients who had jejunoileal bypasses. It is suggested that dietary carbohydrate may have contributed to the accretion of liver fat in these 12 patients.

  18. Appraisal of adaptive neuro-fuzzy computing technique for estimating anti-obesity properties of a medicinal plant.

    Science.gov (United States)

    Kazemipoor, Mahnaz; Hajifaraji, Majid; Radzi, Che Wan Jasimah Bt Wan Mohamed; Shamshirband, Shahaboddin; Petković, Dalibor; Mat Kiah, Miss Laiha

    2015-01-01

    This research examines the precision of an adaptive neuro-fuzzy computing technique in estimating the anti-obesity property of a potent medicinal plant in a clinical dietary intervention. Even though a number of mathematical functions such as SPSS analysis have been proposed for modeling the anti-obesity properties estimation in terms of reduction in body mass index (BMI), body fat percentage, and body weight loss, there are still disadvantages of the models like very demanding in terms of calculation time. Since it is a very crucial problem, in this paper a process was constructed which simulates the anti-obesity activities of caraway (Carum carvi) a traditional medicine on obese women with adaptive neuro-fuzzy inference (ANFIS) method. The ANFIS results are compared with the support vector regression (SVR) results using root-mean-square error (RMSE) and coefficient of determination (R(2)). The experimental results show that an improvement in predictive accuracy and capability of generalization can be achieved by the ANFIS approach. The following statistical characteristics are obtained for BMI loss estimation: RMSE=0.032118 and R(2)=0.9964 in ANFIS testing and RMSE=0.47287 and R(2)=0.361 in SVR testing. For fat loss estimation: RMSE=0.23787 and R(2)=0.8599 in ANFIS testing and RMSE=0.32822 and R(2)=0.7814 in SVR testing. For weight loss estimation: RMSE=0.00000035601 and R(2)=1 in ANFIS testing and RMSE=0.17192 and R(2)=0.6607 in SVR testing. Because of that, it can be applied for practical purposes. PMID:25453384

  19. Anti-obesity activity of diglyceride containing conjugated linoleic acid in C57BL/6J ob/ob mice

    OpenAIRE

    Hue, Jin-Joo; Lee, Ki Nam; Jeong, Jae-Hwang; Lee, Sang-Hwa; Lee, Young Ho; Jeong, Seong-woon; Nam, Sang Yoon; Yun, Young Won; Lee, Beom Jun

    2009-01-01

    This study was to investigate the anti-obesity effects of diglyceride (DG)-conjugated linoleic acid (CLA) containing 22% CLA as fatty acids in C57BL/6J ob/ob male mice. There were four experimental groups including vehicle control, DG, CLA, and DG-CLA. The test solutions of 750 mg/kg dose were orally administered to the mice everyday for 5 weeks. CLA treatments significantly decreased mean body weight in the obese mice throughout the experimental period compared to the control (p < 0.01). All...

  20. Anti-obesity effects of Rapha diet® preparation in mice fed a high-fat diet

    OpenAIRE

    Kim, Jihyun; Kyung, Jangbeen; Kim, Dajeong; Choi, Ehn-Kyoung; Bang, Paul; Park, Dongsun; Kim, Yun-Bae

    2012-01-01

    The anti-obesity activities of Rapha diet® preparation containing silkworm pupa peptide, Garcinia cambogia, white bean extract, mango extract, raspberry extract, cocoa extract, and green tea extract were investigated in mice with dietary obesity. Male C57BL/6 mice were fed a high-fat diet (HFD) containing 3% Rapha diet® preparation for 8 weeks, and blood and tissue parameters of obesity were analyzed. The HFD markedly enhanced body weight gain by increasing the weights of epididymal, perirena...

  1. Uso de drogas antiobesidade entre estudantes universitários Use of anti-obesity drugs among college students

    Directory of Open Access Journals (Sweden)

    Maria do Carmo de Carvalho e Martins

    2011-10-01

    Full Text Available OBJETIVO: Avaliar o uso de drogas antiobesidade entre estudantes de uma universidade pública. MÉTODOS: Estudo transversal com amostra probabilística constituída por 664 universitários. Foram observadas variáveis socioeconômicas, antropométricas e uso das drogas. O índice de massa corpórea (IMC e circunferência da cintura (CC foram classificados segundo critérios da Organização Mundial de Saúde. RESULTADOS: Uso atual ou anterior de agentes antiobesidade foi referido por 6,8% dos estudantes. As anfetaminas e as aminas simpaticomiméticas (40,5% foram as drogas mais usadas. Entre aqueles que referiram uso de agentes antiobesidade, 62,2% eram do sexo feminino. Apenas 31,1% das prescrições foram indicadas por médicos. As médias de IMC e CC foram maiores entre estudantes que referiram uso de tais drogas, mas 47% deles foram classificados como eutróficos pelo IMC, e 76,5% apresentavam medida de CC normal. CONCLUSÃO: O uso de drogas antiobesidade se mostrou preocupante, principalmente pela elevada proporção de uso sem indicação ou prescrição médica.OBJECTIVE: To evaluate the use of anti-obesity drugs among students attending a public university. METHODS: This was a cross sectional random study of 664 college students. Drug use, socioeconomic, and anthropometric variables were observed. Body mass index (BMI and waist circumference (WC were classified according to World Health Organization criteria. RESULTS: Current or previous use of anti-obesity drugs was reported by 6.8% of students. Amphetamine and sympathomimetic amines (40.5% were the most commonly used drugs. Among those who reported use of anti-obesity agents, 62.2% were female. Only 31.1% of medications were prescribed by doctors. Mean BMI and WC were higher among students reporting the use of such drugs, but 47% of them were classified as eutrophic by BMI, and 76.5% had normal WC measure. CONCLUSION: The use of anti-obesity drugs among college students is of concern

  2. Anti-obesity activity of hen egg anti-lipase immunoglobulin yolk, a novel pancreatic lipase inhibitor

    OpenAIRE

    Hirose, Mai; Ando, Taishi; Shofiqur, Rahman; Umeda, Kouji; Kodama, Yoshikatsu; Van Nguyen, Sa; Goto, Tsuyoshi; Shimada, Masaya; Nagaoka, Satoshi

    2013-01-01

    Background There is completely no report about both hen egg anti-lipase immunoglobulin yolk (IgY) and its anti-obesity action. Thus, we tried to isolate and characterize a novel anti-lipase immunoglobulin from hen egg yolk. Moreover, we investigated whether hen egg yolk anti-lipase IgY inhibits pancreatic lipase activity in vitro, and examined its ability to prevent obesity in a murine high fat diet-induced obesity model. Methods We determined the inhibitory action of Anti-lipase IgY on lipas...

  3. A systematic review of anti-obesity medicinal plants - an update.

    Science.gov (United States)

    Hasani-Ranjbar, Shirin; Jouyandeh, Zahra; Abdollahi, Mohammad

    2013-01-01

    Obesity is the most prevalent health problem affecting all age groups, and leads to many complications in the form of chronic heart disease, diabetes mellitus Type 2 and stroke. A systematic review about safety and efficacy of herbal medicines in the management of obesity in human was carried out by searching bibliographic data bases such as, PubMed, Scopus, Google Scholar, Web of Science, and IranMedex, for studies reported between 30th December 2008 to 23rd April 2012 on human or animals, investigating the beneficial and harmful effects of herbal medicine to treat obesity. Actually we limited our search to such a narrow window of time in order to update our article published before December of 2008. In this update, the search terms were "obesity" and ("herbal medicine" or "plant", "plant medicinal" or "medicine traditional") without narrowing or limiting search items. Publications with available abstracts were reviewed only. Total publications found in the initial search were 651. Total number of publications for review study was 33 by excluding publications related to animals study.Studies with Nigella Sativa, Camellia Sinensis, Crocus Sativus L, Seaweed laminaria Digitata, Xantigen, virgin olive oil, Catechin enriched green tea, Monoselect Camellia, Oolong tea, Yacon syrup, Irvingia Gabonensi, Weighlevel, RCM-104 compound of Camellia Sinensis, Pistachio, Psyllium fibre, black Chinese tea, sea buckthorn and bilberries show significant decreases in body weight. Only, alginate-based brown seaweed and Laminaria Digitata caused an abdominal bloating and upper respiratory tract infection as the side effect in the trial group. No other significant adverse effects were reported in all 33 trials included in this article.In conclusion, Nigella Sativa, Camellia Synensis, Green Tea, and Black Chinese Tea seem to have satisfactory anti-obesity effects. The effect size of these medicinal plants is a critical point that should be considered for interpretation. Although there

  4. Parent and child interactions with two contrasting anti-obesity advertising campaigns: a qualitative analysis

    Science.gov (United States)

    2014-01-01

    Background Social marketing has been proposed as a framework that may be effectively used to encourage behaviour change relating to obesity. Social advertising (or mass media campaigning) is the most commonly used social marketing strategy to address the issue of obesity. While social advertising has the potential to effectively communicate information about obesity, some argue that the current framing and delivery of these campaigns are ineffective, and may cause more harm than good. Methods We used a qualitative advertising reception study. 150 family groups (comprised of 159 parents and 184 children) were shown two Australian government anti-obesity advertisements: Measure Up (focused on problems associated with obesity) and Swap It (focused on solutions for obesity). Families were engaged in a discussion about the visual appeals, verbal messages and their perceptions about the impact of the advertisements on behavioural change. Open coding techniques and a constant comparative method of analysis was used to interpret the data. Results Many parents had strong personal resonance with the visual imagery within the campaigns. While Swap It had strong ‘likeability’ with children, many children believed that the messages about overweight and obesity were less personally relevant because they did not perceive themselves to be overweight. The content and delivery style of the verbal messages (the serious risk focused message in Measure Up compared to the upbeat, fun practical message in Swap It) influenced how different audiences (parents and children) interpreted the information that was presented. Parents assimilated practical and instructive messages, while children assimilated messages about weight loss and weight gain. Parents and children recognised that the campaigns were asking individuals to take personal responsibility for their weight status, and were at times critical that the campaigns did not tackle the broader issues associated with the causes and

  5. Clinical observation of gastric bypass in treatment of patients with type 2 diabetes mellitus%胃转流术治疗2型糖尿病的临床疗效:附214例报告

    Institute of Scientific and Technical Information of China (English)

    郭渝明; 李广阔; 霍芊竹; 陈俊; 邓开

    2013-01-01

      目的Roux-en-Y式胃转流术(RY-GBP)是2型糖尿病患者接受外科手术治疗的主要术式之一。本研究旨在进一步验证RY-GBP的手术治疗效果。方法214例2型糖尿病(T2DM)患者均行RY-GBP术,术中根据体质指数和胰岛素抵抗情况,选择合适的残胃(Pouch)容积和空肠袢长度。患者于术前和术后3,6,12个月行OGTT试验,并测定空腹血清胰岛素(FIns)、空腹血清C肽(FC-P)、糖化血红蛋白(HbAlc)、体重指数(BMI),密切关注患者术后的降糖药服用情况及糖尿病并发症改善情况。结果214例患者中,51例(23.8%)术后出院时即达治愈标准,停用降糖药物,78例(36.4%)于术后0~3个月内停药,21例(9.8%)于术后3~6个月内停药,18例(8.4%)于术后6~12个月内停药。另外46例(21.5%)12个月后仍服用降糖药物,但药物剂量有不同程度地减少,尚在进一步观察中。上述病例在术后3,6,12个月的各项检测指标均有所改善,近期治愈率达78.5%(168/214)。本组无死亡病例,相关并发症包括吻合口出血2例,吻合口溃疡7例,胃瘫21例,营养不良3例,贫血8例,在给予相应治疗后均缓解。结论RY-GBP胃转流术对肥胖型和非肥胖型2型糖尿病均有良好治疗效果,对非肥胖型2型糖尿病的治疗效果更值得进一步深入研究。%  Objective Gastric bypass(GBP), especially Roux-en-Y, is the main surgical procedure in patients with type 2 diabetes mellitus(T2DM). The present study focused on the evaluation of efficiency of Roux-en-Y Gastric bypass(RY-GBP) in T2DM patients. Methods Two hundred and fourteen patients with T2DM were operated according to the RY-GBP procedures, and gastric pouch as well as Roux limb were selected respectively by the BMI and insulin resistance. Blood glucose alterations(OGTT), Fins, FC-P, HbAlc, BMI, related complications and anti-sugar drugs were observed at

  6. Estudos endoscópico e histológico prospectivos e sequenciais da bolsa gástrica em 130 pacientes obesos mórbidos submetidos à bypass gástrico em Y-de-Roux Prospective sequential endoscopic and histologic studies of the gastric pouch in 130 morbidly obese patients submitted to Roux-en-Y gastric bypass

    OpenAIRE

    Attila Csendes; Gladys Smok; Ana Maria Burgos; Moira Canobra

    2012-01-01

    RACIONAL: Bypass gástrico em Y-de-Roux é a operação bariátrica mais comumente realizada. Pequena bolsa gástrica é criada, deixando uma anastomose gastrojejunal estreita, com uma alça jejunal mais comprida. Muito pouco é conhecido sobre o comportamento desta bolsa em anos após o procedimento. OBJETIVO: Determinar através de estudos prospectivos endoscópico e histológico seqüenciais o tamanho da bolsa gástrica, o diâmetro da anastomose e o comportamento da infecção por H. pylori após a operação...

  7. 保留不同胃容量的Roux-en-Y胃旁路术对糖尿病大鼠降糖效果的比较%Comparative effects of Roux-en-Y gastric bypass procedures preserving different gastric volume on blood glucose in Goto-Kakizaki rats

    Institute of Scientific and Technical Information of China (English)

    邹忠东; 焦亚彬; 王祎波; 王畅; 刘斌; 王瑜; 黄盛

    2012-01-01

    Objective To compare the effects of Roux-en-Y gastric bypass (RYGBP) procedures preserving different gastric volume on blood glucose of rats with non-obese type 2 diabetes.Methods A total of 36 Goto-Kakizaki rats randomly underwent one of the following procedures:gastric bypass with different types of anastomosis including the Roux-en-Y of total stomach excision (n=12),the Roux-en-Y of partial stomach excision (n=12) and the Roux-en-Y of stomach preservation (n=12).Rats were observed for 24 weeks after surgery.Body weight,food intake and fasting blood glucose level were tested at 0 (preoperative),1,3,6,12,24 weeks.Hematoglobin Alc (HbAlc) level was measured at 0, 12,24 weeks and glucose tolerance test (OGTF) was performed in conscious rats before (baseline) and then 30,60,120,and 180 minutes.Change of blood glucose over time was depicted. Area under curve (AUC) of glucose tolerance were calculated.Results Compared with preoperative levels,the weight and food intake of all the rats were significantly decreased at 1 week after surgery (P<0.01).At 3 weeks after operation,the weight and food intake were significantly increased compared with 1 week after operation in the Roux-en-Y of partial stomach excision and the Roux-en-Y of stomach retention (P<0.01).In the Roux-en-Y of total stomach excision,the weight and food intake were significantly lower compared with other two groups (P<0.05).At 24 weeks after operation,the levels of fasting blood glucose were (7.3±1.5),(7.5±2.0) and (8.3±1.3) mmol/L,which were lower than the preoperative levels [(13.2±1.6),(13.6±2.5) and (12.9±2.0) mmol/L,P<0.01 ] in the three groups.There were no significant differences among the three groups (P>O.05).At 24 weeks after operation,the HbA1c levels were (6.3±1.3)%,(6.4±2.0)% and (7.0±1.3)%,which were lower than the preoperative level[ (10.2±2.6)%,(9.6±2.5) and (9.9±2.0)%,P<0.01 ].There were no significant differences among the three groups(P>0.05).The trend

  8. Effect of gastric bypass surgery on fasting blood glucose and pancreatic islet cell in type 2 diabetic rats%胃旁路术对血糖及胰岛细胞的影响

    Institute of Scientific and Technical Information of China (English)

    史逸华; 郑志坚; 戴灵波

    2013-01-01

    Objective To study the effect and mechanism of gastric bypass surgery on type 2 diabetic rats.Methods The models of type 2 diabetic rats were induced by stretozotocin and 20 diabetic rats were randomly divided into 2 groups:diabetes-operation group (DO group,n =10)and diabetes-control group(DC group,n =10).20 normal rats were randomly divided into 2 groups:normal-operation(NO group,n =10) and normalcontrol group(NC group,n =10).Rats in DO and NO group underwent GBP and rats in DC group and NC group underwent sham operation.Fasting blood glucose(FBG) levels of rats in each group were detected before operation and on 72 h,1th week,4th week,8th week after operation.On the 8th week after operation,pancreas tissues were harvested for HE staining and immunofluorescence,histological changes observed.Results The FBG levels of rats were not statistically significant different before operation between DO group and DC group or between NO group and NC group (P > 0.05).After operation,the FBG levels of rats in DO group gradually declined (P < 0.05).FBG levels of rats in DO group were lower after operation than before operation(P <0.05) ; After operation FBG levels of rats were higher in DO group than in NO group and NC group at the same time point (P <0.05).In DC group,the difference of FBG levels of rats at different time point was not statistically significant(P > 0.05).The difference of FBG had no statistically significance between the different time points of the same group or between the same time point of different groups (P > 0.05).HE staining showed that,in DO group,newborn small islets appeared in pancreas which increased the number of islet.The new islets were smaller,mostly around the pancreatic duct and the structure was similar to that of the normal islets.Immunofluorescence staining also showed that the number of islets increased.Insulin immunofluorescence found more isolated small islets composed of two or three insulin positive cells.Insulin and

  9. Resolution of diabetes mellitus and metabolic syndrome in normal weight 24-29 BMI patients with one anastomosis gastric bypass Resolución de la diabetes mellitus y del síndrome metabólico

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    M. García-Caballero

    2012-04-01

    Full Text Available Introduction: Diabetes mellitus type 2 (DMT2 is a major cause of death in the world. The medical therapy for this disease has had enormous progress, but it still leaves many patients exposed to the complications developed from the disease. It is well known the beneficial effects of bariatric surgery in obese diabetic patients, however it is important to investigate if the same principles of bariatric surgery that improve diabetes in obese patients, could be applied to non obese normal weight diabetics. Material and methods: Thirteen diabetic patients operated by One Anastomosis Gastric Bypass (BAGUA, were evaluated in the preoperative period and 1,3 and 6 months after surgery. Body weight and composition, Fasting Plasma Glucose, HbA1c levels, blood pressure and serum lipids levels were analyzed, as well as the monitoring of the immediate postoperative treatment necessities for Diabetes and other metabolic syndrome comorbidities. Results: After the surgery the 77% of the patients resolves its T2DM, 46% from surgery, and rest noted an significant improvement of the disease in spite of having a C peptide level near to zero some of the patients. The comorbidities, mainly hypertension and lipid abnormalities experience improvement early. All patients reduce their weight and the amount of fat mass until values consistent with their age and height. Conclusions: The One Anastomosis Gastric Bypass leads to resolution or improvement of T2DM in non obese normal weight patients. The best results are obtained in patients with few years of diabetes, without or short term use of insulin treatment and high C-peptide levels.Introducción: La diabetes mellitus de tipo 2 (DMT2 es una causa principal de muerte a escala mundial. El tratamiento médico de esta enfermedad ha progresado tremendamente pero sigue dejando a muchos pacientes expuestos a las complicaciones derivadas de la enfermedad. Son bien conocidos los efectos beneficiosos de la cirugía bariátrica en

  10. Bypass gástrico en Y de Roux para el tratamiento de pacientes con diabetes mellitus tipo II con IMC de 30 a 35 kg/m² Roux-en-Y gastric bypass for treatment of patients with DM type 2 and BMI of 30 to 35 Kg/m²

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    S. Navarrete Aulestia

    2012-08-01

    Full Text Available La incidencia de obesidad y una de sus comorbilidades más temida la diabetes mellitus tipo II está en aumento y no pareciera haber tratamiento médico que ayude a controlar estas pandemias. Existe una técnica quirúrgica bariátrica, el Bypass Gástrico en Y de Roux (BGYR que es segura y no sólo ayuda a controlar el exceso de peso sino también produce resultados alentadores en el control y remisión de la diabetes. Métodos: Se presentan 15 pacientes con IMC entre 30 y 35 kg/mt² diabéticos tipo II seleccionados sometidos a BGYR por laparoscopia con seguimiento de un año. Resultados: Se operaron 14 mujeres y un hombre con los siguientes valores promedios: Edad: 37 años, Peso: 88,3 kg, IMC: 32,8 kg/mt², Glicemia: 120 ± 38,8 mg%, HbA1c: 7,6% ± 0,73. 40% de hipertensión arterial y 33,3% dislipidémicos. El tiempo quirúrgico promedio fue de 75 minutos, dos días de hospitalización bajo índice de complicaciones y sin mortalidad. Se logró una remisión de la diabetes en el 93%, de los casos, con descensos de la glicemia y HbA1c significativos (p ≤ 0,05 y p ≤ 0,001 respectivamente con un control de la dislipidemia del 100% y 83,3% de la HTA. Conclusiones: El BGYR en obesos tipo I diabéticos seleccionados es una técnica segura y eficaz en el control metabólico y de la obesidad.Background: The incidence of obesity and its most feared comorbidity, diabetes mellitus type 2, is increasing and there would not seem to be any medical treatment to help control these pandemics. However, there is a bariatric surgery technique, the Roux-en-Y Gastric Bypass (RYGB, which is safe and not only helps control excess weight, but produces encouraging results in the control and remission of diabetes. Methods: We present 15 selected patients with a BMI between 30 and 35 kg/mt² and diabetes type 2 who underwent a laparoscopic RYGB with of one-year follow-up. Results: A total of 14 women and one man were operated with the following average values: age

  11. 十二指肠空肠旷置术与Roux-en-Y胃旁路术治疗2型糖尿病的疗效对比%Effect of duodenal-jejunal bypass vs.Roux-en-Y gastric bypass for type Ⅱ diabetes

    Institute of Scientific and Technical Information of China (English)

    都敏; 鲍兴; 张杰; 戴璟瑜; 张环; 彭海峰

    2012-01-01

    Objective To study the curative effects of Roux-en-Y gastric bypass vs.duodenal-jejunal bypass for STZ-induced type 2 diabetic SD rats.Methods Twenty-one type Ⅱ diabetic rats were randomly divided into Roux-en-Y gastric bypass group and duodenal-jejunal bypass group.The fasting blood glucose,fasting plasma insulin level,the body weight and the food intake were measured and recored before and after operation at the 1st,2nd,3rd,4th and 8th week postoperatively.Results As compared with preoperation,fasting plasma glucose levels in DJB group were markedly declined at the 3rd,4th and 8th week (18.30 ±4.4 vs.11.30 ±5.02 vs.9.80 ±4.81 vs.7.90 ±3.38,P <0.05),fasting plasma insulin levels increased significantly at the 3rd,4th and 8th week (11.10 ± 5.69 vs.15.50 ± 3.68 vs.16.60 ±3.67 vs.16.70 ±3.74,P <0.05).Body weight was decreased but the difference was statistically significant only at the 8th week after surgery (368.30 ±23.69 vs.352.20 ±35.28,P<0.05).Food intake was markedly declined only at the 1st week after DJB (30.40 ± 1.94 vs.15.30 ± 10.78,P <0.05).In the RYGB group,as compared with preoperation,fasting plasma glucose levels were markedly declined at 3rd,4th and 8th week (19.30±4.89 vs.13.50±4.05 vs.9.80±3.08 vs.8.60 ±2.71,P<0.05),and body weight was also markedly declined at 3rd,4th and 8th week (370.70 ±41.88 vs.343.20 ±31.16 vs.322.70 ± 34.76 vs.304.70 ± 29.70,P < 0.05),insulin levels significant increased at 3rd,4th and 8th week (10.50 ± 4.13 vs.16.50 ± 4.93 vs.18.80 ± 3.36 vs.18.40 ± 2.82,P < 0.05).Food intake was decreased significantly after surgery (12.90 ± 7.82 vs.20.10 ± 1.41 vs.19.80 ± 2.35 vs.20.70 ± 1.83 vs.20.30 ±2.42,P <0.05).From the baseline to 8th week,no significant difference was found between RYGB group and DJB group in fasting plasma glucose and insulin levels (P > 0.05),but there was significant difference in weight loss between two groups (P < 0.05).Food intake after surgery was

  12. Your diet after gastric bypass surgery

    Science.gov (United States)

    ... NOT gulp. Ask your provider before using a straw, since it may bring air in your stomach. ... calories. Avoid drinks that have sugar, fructose, or corn syrup in them. Avoid carbonated drinks (drinks with ...

  13. Derivações gástricas em y- de- roux com anel de silicone para o tratamento da obesidade: estudo das complicações relacionadas com o anel Roux-en-y gastric bypass with silicone ring for the obesity treatment: study of the complications related to the ring

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    Alexandre Amado Elias

    2011-12-01

    Full Text Available RACIONAL: O anel de silicone é utilizado como fator de contensão do bypass gástrico em Y-de-Roux para induzir maior perda ponderal. No entanto, ele pode ter alguns inconvenientes nesta restrição forçada. OBJETIVO: Analisar as complicações relacionadas ao anel em pacientes submetidos à operação de bypass gástrico em Y-de-Roux. MÉTODOS: De 1994 a 2005, 7 000 pacientes foram submetidos à bypass gástrico em Y-de-Roux com anel de silicone para o tratamento da obesidade mórbida. Apenas 50% foram acompanhados de dois a 11 anos. A perda média de peso em excesso foi de cerca de 85%. Mas complicações do anel foram registrados em 160 pacientes (2,28% do total e 4,56% dos pacientes seguidos. Assim, esta série é composta de 38 pacientes do sexo masculino (23,8% e 122 pacientes do feminino (76,2% com idade média de 44 anos e IMC de 54,4 kg/m². RESULTADOS: Cinco tipos de complicações do anel foram encontradas. A mais frequente foi o de deslocamento (61% causando sintomas de obstrução. A segunda, foi a erosão do anel de luz (22%, causando dor epigástrica e náuseas. A presença de anel estreito, anel aberto e a inadequação do mesmo são outras complicações que acorreram, porém em menor percentual. CONCLUSÕES: As complicações do anel ocorrem em baixa frequência. Sua remoção, cirúrgica ou endoscópica, é o tratamento mais usual, mas com sua realização o paciente tende a recuperar o peso perdido.BACKGROUND: The silicone ring is used as containment factor of the Roux-en-Y gastric bypass to induce greater ponderal loss. However, it may have some inconveniences from this stressed restriction. AIM: To analyze the complications related to silicone ring in patients who underwent Roux-en-Y gastric bypass surgery with silicon ring. METHODS: From 1994 to 2005, 7 000 patients were submitted to Roux-in-Y gastric bypass with silicone ring in order to treat morbid obesity. Only 50% were followed from two to 11 years. The mean excess

  14. Mitochondria as pharmacological targets: the discovery of novel anti-obesity mitochondrial uncouplers from Africa's medicinal plants.

    Science.gov (United States)

    Ocloo, Augustine; Dongdem, Julius Tieroyaare

    2012-01-01

    Obesity results from prolonged positive imbalance between energy in take and expenditure. When food intake chronically exceeds the body's energy need, an efficient metabolism results in the storage of the excess energy as fat. Mitochondria are the main centre for energy production in eukaryotic cells. Mitochondrial proton cycling is responsible for a significant proportion of basal or standard metabolic rate, therefore, further uncoupling of mitochondria may be a good way to increase energy expenditure and hence represent a good pharmacological target for the treatment of obesity. This implies that, any chemical agent or photochemical compound that further uncouples the mitochondria in vivo without having any effect on mitochondria activity could be a potential target in finding treatment for obesity. In the past, uncoupling by 2, 4-dinitrophenol has been used this way with notable success. This paper discusses the mitochondria as targets in the discovery of potential plant natural anti-obesity products from Africa's rich rainforests. PMID:23983343

  15. Laparoscopic Roux-en-Y gastric bypass for morbid obesity: Follow-up results in 121 patients%121例腹腔镜Roux-en-Y胃空肠吻合术后随访结果

    Institute of Scientific and Technical Information of China (English)

    宫轲; Michel Gagner; Alfons Pomp; Taghreed A

    2007-01-01

    目的 探讨腹腔镜Roux-en-Y胃空肠吻合术(laparoscopic Roux-en-Y gastric bypass,LRYGBP)治疗病态肥胖的术后营养和代谢方面的变化.方法 121例LRYGBP,男40例,女81例.分别测定术前1个月及术后6个月的体重指数(body mass index,BMI).对比分析6个月、12个月,24个月血清铁(Fe)、钙(Ca)、锌(Zn)、硒(Se)及维生素A(VitA)、维生素D(VitD)、维生素B12(VitB12)和甲状旁腺素(parathyroid hormone,PTH)的水平变化.结果 术前1个月BMI(47.00±7.15)kg/m2,术后6个月BMI(33.79±6.06) kg/m2,BMI下降(13.21±5.47)kg/m2 (t=26.103,P=0.000).术后血清Fe 、 Ca 、Zn、 Se及VitA、VitD、VitB12均在正常范围,其中术后6个月血清Zn、Se和VitA水平虽然在正常范围内,但分别有19.5%(17/87)、22.7%(20/88)和33.7%(28/83)的患者低于正常水平,但术后2年仅有6.7%(2/30)、11.5%(3/26)和17.2%(5/29)的患者低于正常水平.血清PTH术后 6个月11~161 pg/ml,(66±34)pg/ml、1年24~154 pg/ml,(72±34)pg/ml、2年21~194 pg/ml,(75±40)pg/ml (正常值9~44 pg/ml).结论 LRYGBP治疗病态肥胖是有效、安全的.术后2年血清Fe、Ca及VitD 、VitB12均正常;血清锌、硒及维生素A经术后6个月给予补充剂大多接近正常;血清PTH水平明显高于正常.建议患者术后长期服用复合维生素、矿物质补充剂,定期到医院随访.

  16. Micronutrients deficiencies following laparoscopic gastric bypass in patients with morbid obesity%腹腔镜胃旁路术后病态肥胖症患者微量营养素缺乏的诊治

    Institute of Scientific and Technical Information of China (English)

    宫轲; Michel Gagner; Sergio J Bardaro

    2010-01-01

    Objective To evaluate the changes of micronutrients in patients with morbid obesity after laparoscopic Roux-en-Y gastric bypass surgery (LRYGBP). Methods We retrospectively reviewed 121 patients diagnosed with morbid obesity who underwent LRYGBP and evaluated serum Iron (Fe),calcium (Ca), zinc (Zn), selenium (Se), vitamin A (VitA), 25-hydroxy vitamin D3 (VitD), vitamin B12( VitB12 ) and parathormone (PTH) measured at 6-month, 12-month and 24-month after LRYGBP. Results A cohort of 121 patients underwent LRYGBP. The mean body mass index (BMI) before LRYGBP was (47 ±7) kg/m2. At 6 months after surgery, the mean BMI was (34 ±6) kg/m2. Postoperative mean BMI decreased significantly ( P< 0.01 ) 6 months after the surgery. Within the following 2 years, serum Fe, Ca,Zn, Se, VitA, VitD, VitB12 was normal. In contrast serum PTH remained continuously at a higher level than normal. Conclusions This study confirms that LRYGBP is a reliable and safe weight loss method for the patients suffering from morbid obesity. After surgery, serum Ca, Zn, Se metabolisms and PTH levels are altered in these patients. Therefore multi-vitamin and mineral supplementation are strongly recommended in all patients after LRYGBP.%目的 探讨行腹腔镜胃旁路术后病态肥胖症患者血清微量营养素的变化. 方法回顾性分析121例病态肥胖症患者腹腔镜胃旁路术后6、12、24个月血清铁(Fe)、钙(Ca)、锌(Zn)、硒(Se)及维生素A(VitA)、维生素D(VitD)、维生素B12(VitB12)和甲状旁腺素(PTH)水平的变化.结果 本组121例病态肥胖症患者术前1个月平均体质量指数(body mass index,BMI)为(47±7)kg/m2,术后6个月平均BMI为(34±6)kg/m2,术后BMI平均下降(13±5)kg/m2(P<0.01).在术后的2年随访中,血清Fe、Ca、Zn、Se、VitA、VitD、VitB12均在正常范围.虽然一些患者的血清Zn、Se和VitA水平偏低,但接近正常.而血清PTH始终高于正常水平,术后6、12、24个月分别升高了(22±34)pg/ml、(28±34)pg

  17. Effects of gastric bypass on blood glucose in rats with diabetes mellitus%胃转流术对糖尿病大鼠降糖作用的实验研究

    Institute of Scientific and Technical Information of China (English)

    李蔚; 刘宁青; 李萌; 赵莉

    2012-01-01

    目的 研究胃肠转流手术(GBP)对非肥胖型糖尿病大鼠的降糖效果与术后进食量、体重的关系.方法 健康雄性wistar大鼠,腹腔注射链脲佐菌素(STZ)建立糖尿病模型.随机分成3组,O组:GBP手术组;F组:饮食控制组;C组:空白对照组.观察各组大鼠体重、平均进食量,分别测定术前、术后1、2、3、4、8周空腹及灌服葡萄糖30 min后血糖水平.结果 O组GBP后4周,空腹和灌服葡萄糖后血糖分别由(20.8±4.9)、(30.2±3.1)mmol/L下降到(11.6±2.9)、(16.6±3.1)mmol/L (P<0.01).O组体重改变无统计学意义.F组控制平均进食量约为O组的1/3并致体重显著下降,血糖下降没有O组明显.结论 胃转流术对糖尿病大鼠具有明显治疗作用,其降糖作用与术后体重下降及进食量无关.%Objective To investigate the effects of gastric bypass ( GBP ) on hypoglycemic activity, food-intake after GBP and body weight in rats with non-obesity diabetes mellitus. Methods The animal models with diabetes mellitus were established in 24 male Wistar rats by intraperitoneal injection with STZ, then the rats were randomly divided into 3 groups:group 0 ( GBP ),group F ( food restriction ) and group C ( blank controls ). The blood glucose concentrations were measured respectively at fasting and postprandial condition before and on the 1st,2nd,3rd,4th and 8th week after GBP for all the rats, and the rats'body weight and average food-intake were detected simultaneously. Results At the 4th week after GBP,the fasting and postprandial blood glucose levels in group 0 were significantly decreased from ( 20. 8±4. 9 ),( 30. 2±3. 1 ) mmol/L to (11. 6±2. 9),( 16. 6±3. 1 ) mmol/L,respectively ( P < 0. 01 ). However there was no significant difference in the rats' weight changes in group 0. The average food-intake in group F was about one-third of group 0,furthermore,the rats' body weight was decreased, but the decrease of body weight was not as obvious as that in group 0

  18. Potency of turmeric (Curcuma longa L. extract and curcumin as anti-obesity by inhibiting the cholesterol and triglycerides synthesis in HepG2 cells

    Directory of Open Access Journals (Sweden)

    Iwan Budiman

    2015-05-01

    Full Text Available Background: Adipocytes accumulate triacylglycerol when excessive food consumption. Adipocyte dysfunction plays an important role in the obesity development. People with a body weight 40 % heavier than the average body weight population at risk of death two times greater than the average body weight. The use of anti-obesity drugs have many side effects, so it is necessary to find the anti-obesity drug with low toxicity. This ex vivo study was conducted to determine the activity of C. longa L. extract in inhibiting triglycerides and cholesterol synthesis and lipid droplet formation on HepG2 cells compared to curcumin. Methods: Anti-obesity activity includes reduced formation of lipid droplet in HepG2 cells can be observed using oil red O staining method. The measurement of triglyceride level was performed according to Randox protocol using Randox TR 210 assay kit. Lipolytic activity by measuring cholesterol levels was performed based on Randox CH 200 kits. Results: This study suggested that the extract of C. longa L. and curcumin have potential anti-obesity compounds. C. longa L. extract have higher activity in inhibiting triglycerides and cholesterol synthesis compared to curcumin with inhibition activities 70.43% and 66.38% respectively in the highest concentration. Conclusion: The C. longa extract posses the anti-adipogenesis potential on inhibiting the synthesis of triglycerides and cholesterol and lipid droplet formation in HepG2 cell as anti-obesity parameters better than curcumin. [Int J Res Med Sci 2015; 3(5.000: 1165-1171

  19. Avaliação da vitalidade fetal e resultados perinatais em gestações após gastroplastia com derivação em Y de Roux Assessment of fetal vitality and perinatal results in pregnancies after gastroplasty with Roux-en-Y gastric bypass

    Directory of Open Access Journals (Sweden)

    Roseli Mieko Yamamoto Nomura

    2010-01-01

    Full Text Available OBJETIVO: Analisar os resultados da avaliação da vitalidade fetal de gestações após gastroplastia com derivação em Y de Roux, verificando as complicações maternas e os resultados perinatais. MÉTODOS: No período de julho de 2001 a setembro de 2009, foram analisados, retrospectivamente, dados de prontuário de pacientes com gestação após gastroplastia com derivação em Y de Roux, acompanhadas em pré-natal especializado e cujo parto foi realizado na instituição. Foram analisados os exames de avaliação da vitalidade fetal (cardiotocografia, perfil biofísico fetal e dopplervelocimetria das artérias umbilicais realizada na semana anterior ao parto. As variáveis maternas investigadas foram: dados demográficos, complicações clínicas maternas, tipo de parto, complicações no parto e pós-parto, exames hematimétricos maternos e resultados perinatais. RESULTADOS: Trinta gestações após gastroplastia com derivação em Y de Roux foram identificadas e 24 delas foram submetidas à avaliação da vitalidade fetal. Todas as pacientes apresentaram resultados normais na cardiotocografia, no perfil biofísico fetal e na dopplervelocimetria das artérias umbilicais. Houve um caso de oligohidrâmnio. A principal complicação observada foi anemia materna (Hb OBJECTIVE: To study fetal vitality assessed in pregnancies after gastroplasty with Roux-en-Y gastric bypass'and verify maternal complications and perinatal results. METHODS: Hospital charts of all pregnancies after gastroplasty with Roux-en-Y gastric bypass were reviewed retrospectively. All cases followed at the specialized prenatal care that gave birth in this institution, between July 2001 and September 2009, were reviewed. The assessment of fetal vitality (cardiotocography, fetal biophysical profile and umbilical artery Doppler velocimetry performed in the last week before delivery were analyzed. The maternal variables investigated were: demographic data, maternal complications

  20. Coronary Artery Bypass

    Science.gov (United States)

    ... to 3 days in the Intensive Care Unit (ICU). Life After Bypass After bypass surgery, your doctor will recommend that you join a cardiac rehabilitation program. These programs help you make lifestyle changes ...

  1. The anti-obesity effects of Lactobacillus casei strain Shirota versus Orlistat on high fat diet-induced obese rats

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    Golgis Karimi

    2015-12-01

    Full Text Available Background: Obesity and overweight are major public health problems. Various factors, such as daily nutritional habits, physical inactivity, and genetic, are related to the prevalence of obesity. Recently, it was revealed that the gut microflora may also play an important role in weight management. Thus, this study aimed to determine the anti-obesity effects of Lactobacillus casei strain Shirota (LcS compared with those of orlistat in an animal model fed a high-fat diet (HFD. Design: Thirty-two male Sprague-Dawley rats were assigned to four groups fed various diets as follows: a standard diet group, HFD group, HFD supplemented with LcS (108109 colony-forming units (HFD-LcS group, and HFD group treated with Orlistat (10 mg/kg body weight. After 15 weeks, the weights of organs, body weight, body fat mass and serological biomarkers were measured. In addition, histological analysis of the liver and adipose tissue was performed. Results: Body weight, body mass index, fat mass, leptin and glucose levels were lower, and high-density lipoprotein and adiponectin levels were higher in the HFD-LcS and HFD-orlistat groups than in the HFD group. In addition a significant difference in body fat mass was observed between HFD-LcS group with HFD-orlistat group (19.19±5.76 g vs. 30.19±7.98 g. Although the interleukin-6 level was significantly decreased in the HFD-LcS and HFD-orlistat groups compared with the HFD group, no significant change was observed in other inflammatory biomarkers. Conclusion: The results of the present study show that LcS supplementation improves body weight management and the levels of some related biomarkers. In addition, LcS supplementation showed a better result in fat mass and alanine aminotransferase reduction than Orlistat. Further studies are needed to elucidate the anti-obesity effects of LcS, with a longer period of supplementation.

  2. Anti-obesity efficacy of nanoemulsion oleoresin capsicum in obese rats fed a high-fat diet

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    Kim JY

    2014-01-01

    Full Text Available Joo-Yeon Kim,1,* Mak-Soon Lee,1,* Sunyoon Jung,1 Hyunjin Joo,1 Chong-Tai Kim,2 In-Hwan Kim,3 Sangjin Seo,1 Soojung Oh,1 Yangha Kim11Department of Nutritional Science and Food Management, Ewha Womans University, Seoul, Republic of Korea; 2Functional Materials Research Group, Korea Food Research Institute, Seongnam, Gyeonggi, Republic of Korea; 3Department of Food and Nutrition, Korea University, Seoul, Republic of Korea *These authors contributed equally to this workPurpose: This study determined the effects of oleoresin capsicum (OC and nanoemulsion OC (NOC on obesity in obese rats fed a high-fat diet.Methods: The rats were randomly separated into three groups: a high-fat (HF diet group, HF + OC diet group, and HF + NOC diet group. All groups were fed the diet and water ad libitum for 14 weeks.Results: NOC reduced the body weight and adipose tissue mass, whereas OC did not. OC and NOC reduced mRNA levels of adipogenic genes, including peroxisome proliferator-activated receptor (PPAR-γ, sterol regulatory element-binding protein-1c, and fatty acid-binding protein in white adipose tissue. The mRNA levels of genes related to β-oxidation or thermogenesis including PPAR-α, palmitoyltransferase-1α, and uncoupling protein-2 were increased by the OC and NOC relative to the HF group. Both OC and NOC clearly stimulated AMP-activated protein kinase (AMPK activity. In particular, PPAR-α, palmitoyltransferase-1α, uncoupling protein-2 expression, and AMPK activity were significantly increased in the NOC group compared to in the OC group. NOC decreased glycerol-3-phosphate dehydrogenase activity whereas OC did not.Conclusion: From these results, NOC could be suggested as a potential anti-obesity agent in obese rats fed a HF diet. The effects of the NOC on obesity were associated with changes of multiple gene expression, activation of AMPK, and inhibition of glycerol-3-phosphate dehydrogenase in white adipose tissue.Keywords: oleoresin capsicum

  3. Câncer gástrico após gastroplastia para obesidade mórbida Gastric cancer after gastroplasty for morbid obesity

    Directory of Open Access Journals (Sweden)

    Álvaro Queiroz de Godoy

    2007-08-01

    Full Text Available We report a case of patient in whom a gastric remnant cancer developed about five years after a gastric bypass for morbid obesity. We review the literature on gastric cancer after gastroplasty. Access of gastric remnant after gastroplasty (Fobi-Capella prevents evaluation and treatment of its disorders.

  4. Gastric giardiasis.

    OpenAIRE

    Doglioni, C; De Boni, M.; Cielo, R.; Laurino, L.; Pelosio, P.; P. Braidotti; Viale, G

    1992-01-01

    AIMS: To assess the prevalence of gastric giardiasis in patients undergoing upper gastrointestinal endoscopy, and to define the clinicopathological correlates of gastric Giardia lamblia infection. METHODS: Consecutive gastric biopsy specimens (n = 15,023) from 11,085 patients, taken at Feltre City Hospital (north eastern Italy) from January 1986 to December 1991, were histologically and immunocytochemically examined for the occurrence of G lamblia trophozoites. Three gastric biopsy specimens ...

  5. Anti-obesity effects of Rapha diet® preparation in mice fed a high-fat diet.

    Science.gov (United States)

    Kim, Jihyun; Kyung, Jangbeen; Kim, Dajeong; Choi, Ehn-Kyoung; Bang, Paul; Park, Dongsun; Kim, Yun-Bae

    2012-12-01

    The anti-obesity activities of Rapha diet® preparation containing silkworm pupa peptide, Garcinia cambogia, white bean extract, mango extract, raspberry extract, cocoa extract, and green tea extract were investigated in mice with dietary obesity. Male C57BL/6 mice were fed a high-fat diet (HFD) containing 3% Rapha diet® preparation for 8 weeks, and blood and tissue parameters of obesity were analyzed. The HFD markedly enhanced body weight gain by increasing the weights of epididymal, perirenal, and mesenteric adipose tissues. The increased body weight gain induced by HFD was significantly reduced by feeding Rapha diet® preparation, in which decreases in the weight of abdominal adipose tissue and the size of abdominal adipocytes were confirmed by microscopic examination. Long-term feeding of HFD increased blood triglycerides and cholesterol levels, leading to hepatic lipid accumulation. However, Rapha diet® preparation not only reversed the blood lipid levels, but also attenuated hepatic steatosis. The results indicate that Rapha diet® preparation could improve HFD-induced obesity by reducing both lipid accumulation and the size of adipocytes. PMID:23326287

  6. Anti-obesity effect of Triticum aestivum sprout extract in high-fat-diet-induced obese mice.

    Science.gov (United States)

    Im, Ji-Young; Ki, Hyeon-Hui; Xin, Mingjie; Kwon, Se-Uk; Kim, Young Ho; Kim, Dae-Ki; Hong, Sun-Pyo; Jin, Jong-Sik; Lee, Young-Mi

    2015-01-01

    Obesity is a common disease worldwide that often results in serious conditions including hypertension, diabetes, and hyperlipidemia. Many herbal medicines have been examined with regard to ameliorating obesity. We investigated the anti-obesity effects of 50% EtOH extract of Triticum aestivum sprout (TAEE) in high-fat-diet (HFD)-induced obese mice. TAEE administration (10, 50, or 200 mg/kg) for 6 weeks significantly decreased the body weights, serum total cholesterol (TC), and low-density lipoprotein cholesterol levels in HFD-fed mice. TAEE treatment reduced lipid accumulation in epididymal white adipose tissue (EWAT) and liver. Moreover, TC and lipid levels were decreased by TAEE treatment in liver. Serum leptin and adiponectin concentrations were reduced by TAEE treatment. TAEE-treated mice showed decreases in peroxisome proliferator-activated receptor γ (PPARγ) and fatty acid synthase expression in EWAT. Furthermore, TAEE administration elevated levels of PPARα protein in the liver of HFD-induced obese mice. These results suggest that TAEE supplementation might be beneficial for the treatment and prevention of obesity and related diseases. PMID:25925980

  7. Cell signaling mechanisms of gustatory perception of lipids: can the taste cells be the target of anti-obesity agents?

    Science.gov (United States)

    Dramane, G; Akpona, S; Simonin, A M; Besnard, P; Khan, N A

    2011-01-01

    It has been well propounded that there exists five basic taste modalities, e.g., sweet, sour, bitter, salty and umami. Recent compelling evidence from rodents and human beings raises the possibility for an additional sixth taste modality devoted to the perception of lipids. A number of studies have suggested that lingual CD36, a glycoprotein, mainly expressed by circumvallate papillae of the tongue, might be implicated in the perception of dietary fat taste. G protein-coupled receptors (GPCRs) are important signaling molecules for many aspects of cellular function. It has been recently shown that these receptors particularly GPR40 and GPR120 might also be involved in lipid taste perception. In this article, we highlight the cell activation mechanisms, responsible for the downstream cell signaling which might help understand the lipid-mediated regulation of feeding behavior, critically involved in the development of several diseases like obesity and other metabolic disorders. We also raise the question whether lipid gustatory cells can be the target of anti-obesity strategies. PMID:21728958

  8. Anti-obesity effects of chitosan and psyllium husk with L-ascorbic acid in guinea pigs.

    Science.gov (United States)

    Jun, Sung Chul; Jung, Eun Young; Hong, Yang Hee; Park, Yooheon; Kang, Duk ho; Chang, Un Jae; Suh, Hyung Joo

    2012-04-01

    The aim of this study was to investigate whether L-Ascorbic acid would facilitate the anti-obesity effects of chitosan and psyllium husk in vivo. The study was carried out with male Hartley guinea pigs for 5 weeks. The results show that chitosan itself did not influence body weight gain and food efficiency ratio (FER). However, the addition of L-Ascorbic acid to chitosan decreased these parameters; the body weight gain and FER in the chitosan-2 group (high-fat diet group with 5 % chitosan containing 0.5 % L-Ascorbic acid) was significantly (p psyllium husk did not differ from psyllium husk alone in terms of changes in weight gain, plasma lipid levels, and fat pad weight. We found that the addition of L-Ascorbic acid to chitosan influenced the reduction in body weight gain and FER, and the increase in total fecal weight and fecal fat excretion in guinea pigs fed a high-fat diet. PMID:23065836

  9. MicroRNA Functions in Brite/Brown Fat — Novel Perspectives towards Anti-Obesity Strategies

    Directory of Open Access Journals (Sweden)

    Michael Karbiener

    2014-09-01

    Full Text Available Current anti-obesity strategies are aiming at restricting energy uptake, but still, obesity treatment is far from being satisfactory. The discovery of active brown adipose tissue (BAT in adult humans currently opens new avenues to combat obesity and follow-up complications as it tackles the other site of the energy balance: energy expenditure via non-shivering thermogenesis. This process of energy dissipation in the adipose tissue is tightly controlled, and the elucidation of its regulatory network is a key plank for therapeutic applications. MicroRNAs (miRNAs belong to a novel class of regulatory determinants which are small non-coding RNAs with vital roles in regulating gene expression that also play a role in many human diseases. In this review we summarize miRNAs which have been shown to govern thermogenic, i.e. brite or brown, adipocyte recruitment and physiology. Notably, most miRNAs in this context have so far been characterized solely in mice, revealing a great demand for more human studies. As in the context of other diseases, RNA-based therapeutics have meanwhile entered clinical trials, further exploring the functions of miRNAs in brown and white adipose tissues could result in novel therapeutic approaches to treat obesity and its follow-up complications.

  10. Pre-clinical evolutionary study of Clerodendrum phlomidis as an anti-obesity agent against high fat diet induced C57BL/6J mice

    Institute of Scientific and Technical Information of China (English)

    Vijay R Chidrawar; Krishnakant N Patel; Havagiray R Chitme; Shruti S Shiromwar

    2012-01-01

    Objective: Anti-obesity activity of alcoholic and methanolic extracts of roots of Clerodendrumphlomidis was evaluated against high fat diet (HFD) induced obesity in C57BL/6J female mice. Methods: Obesity was induced by feeding high fat diet for 13 weeks to C57BL/6J female mice and one group was kept on normal chow diet in order to evaluate the effect of Clerodendrumphlomidis on food intake, body weight changes, digestive enzyme activity, lipid metabolism, theromogenesis, adiposities diameter and histology of fat pad. Results: Among these two extracts methanolic extract of Clerodendrum phlomidis (MECP) have shown strong anti-obesity effect compare to alcoholic extract of Clerodendrum phlomidis (AECP). LD50 value was found to be more than 2000 mg/kg. Conclusions: MECP have shown more promising effects than AECP may be because of its multiple mechanisms. Anti-obesity activity produced by MECP is because of inhibition of pancreatic lipase activity which delays the intestinal absorption of dietary fat. Inhibition of pancreatic lipase activity was confirmed by in-vitro studies. MECP also containsβ-sitosterol in abundant amount which was confirmed by HPTLC analysis. Moreover flavonoid content in the plant has anorexic property. By this study we concluded that MECP is beneficial for the suppression of obesity and associated complications like T2DM.

  11. Anti-Obesity Effects of Aster spathulifolius Extract in High-Fat Diet-Induced Obese Rats.

    Science.gov (United States)

    Kim, Sa-Jic; Bang, Chae-Young; Guo, Yuan-Ri; Choung, Se-Young

    2016-04-01

    The aim of this study was to investigate the anti-obesity and antihyperlipidemic efficacy and molecular mechanisms of Aster spathulifolius Maxim extract (ASE) in rats with high-fat diet (HFD)-induced obesity. Rats were separately fed a normal diet or a HFD for 8 weeks, then they were treated with ASE (62.5, 125, or 250 mg/kg) for another 4.5 weeks. The ASE supplementation significantly lowered body weight gain, visceral fat pad weights, serum lipid levels, as well as hepatic lipid levels in HFD-induced obese rats. Histological analysis showed that the ASE-treated group showed lowered numbers of lipid droplets and smaller size of adipocytes compared to the HFD group. To understand the mechanism of action of ASE, the expression of genes and proteins involved in obesity were measured in liver and skeletal muscle. The expression of fatty acid oxidation and thermogenesis-related genes (e.g., PPAR-α, ACO, CPT1, UCP2, and UCP3) of HFD-induced obese rats were increased by ASE treatment. On the other hand, ASE treatment resulted in decreased expression of fat intake-related gene ACC2 and lipogenesis-related genes (e.g., SREBP-1c, ACC1, FAS, SCD1, GPATR, AGPAT, and DGAT). Furthermore, ASE treatment increased the level of phosphorylated AMPKα in obese rats. Similarly, the level of phosphorylated ACC, a target protein of AMPKα in ASE groups, was increased by ASE treatment compared with the HFD group. These results suggest that ASE attenuated visceral fat accumulation and improved hyperlipidemia in HFD-induced obese rats by increasing lipid metabolism through the regulation of AMPK activity and the expression of genes and proteins involved in lipolysis and lipogenesis. PMID:26908215

  12. Dried Pomegranate Potentiates Anti-Osteoporotic and Anti-Obesity Activities of Red Clover Dry Extracts in Ovariectomized Rats

    Directory of Open Access Journals (Sweden)

    Su Jin Kang

    2015-04-01

    Full Text Available Red clover (RC shows potential activity against menopausal symptoms and pomegranates have antioxidative and beneficial effects on postmenopausal symptoms; thus, we investigated whether the anti-climacteric activity of RC could be enhanced by the addition of dried pomegranate concentrate powder (PCP extracts in ovariectomized (OVX rats. Regarding the anti-osteoporotic effects, bone mineral density increased significantly in OVX induced rats treated with 60 and 120 mg/kg of an RC:PCP 2:1 mixture, respectively, compared with OVX control rats. Additionally, femoral, tibia, and L4 bone resorption was decreased in OVX induced control rats treated with the RC:PCP 2:1 mixture (60 and 120 mg/kg, respectively, compared with OVX control rats. Regarding anti-obesity effects, the OVX induced rats treated with 60 and 120 mg/kg of the RC:PCP 2:1 mixture showed a decrease in total fat pad thickness, the mean diameters of adipocytes and the body weights gain compared with OVX induced control rats. The estradiol and bone-specific alkaline phosphatase levels were significantly increased in OVX induced rats treated with the RC:PCP 2:1 mixture (120 mg/kg compared with OVX induced control rats, also, the uterine atrophy was significantly inhibited in 60 and 120 mg/kg of the RC:PCP 2:1 mixture treatment compared with OVX control rats. In conclusion, our results indicate that PCP enhanced the anti-climacteric effects of RC in OVX rats. The RC:PCP 2:1 mixture used in this study may be a promising new potent and protective agent for relieving climacteric symptoms.

  13. Anti-Obese Effect of Glucosamine and Chitosan Oligosaccharide in High-Fat Diet-Induced Obese Rats

    Directory of Open Access Journals (Sweden)

    Lanlan Huang

    2015-04-01

    Full Text Available Objective: This study is to evaluate the anti-obese effects of glucosamine (GLC and chitosan oligosaccharide (COS on high-fat diet-induced obese rats. Methods: The rats were randomly divided into twelve groups: a normal diet group (NF, a high-fat diet group (HF, Orlistat group, GLC high-, middle-, and low-dose groups (GLC-H, GLC-M, GLC-L, COS1 (COS, number-average molecular weight ≤1000 high-, middle-, and low-dose groups (COS1-H, COS1-M, COS1-L, and COS2 (COS, number-average molecular weight ≤3000 high-, middle-, and low-dose groups (COS2-H, COS2-M, COS2-L. All groups received oral treatment by gavage once daily for a period of six weeks. Results: Rats fed with COS1 gained the least weight among all the groups (P < 0.01, and these rats lost more weight than those treated with Orlistat. In addition to the COS2-H and Orlistat groups, the serum total cholesterol (CHO and low-density lipoprotein cholesterol (LDL-C levels were significantly reduced in all treatment groups compared to the HF group (P < 0.01. The various doses of GLC, COS1 and COS2 reduced the expression levels of PPARγ and LXRα mRNA in the white adipose tissue. Conclusions: The results above demonstrated that GLC, COS1, and COS2 improved dyslipidemia and prevented body weight gains by inhibiting the adipocyte differentiation in obese rats induced by a high-fat diet. Thus, these agents may potentially be used to treat obesity.

  14. In vitro anti-diabetic, anti-obesity and antioxidant proprieties of Juniperus phoenicea L. leaves from Tunisia

    Institute of Scientific and Technical Information of China (English)

    2014-01-01

    Objective: To examine chemical composition and antioxidant activity as well as the in vitroα-amylase and pancreatic lipase inhibitory activities of the essential oil and various extracts of Juniperus phoenicea (J. phoenicea). Methods: Essential oil obtained by steam distillation were analyzed by gas chromatography-mass spectrometry technique. The antioxidant activity of the essential oil and various extracts of J. phoenicea were determined by DPPH andβ-carotene bleaching methods. Results: Gas chromatography-mass spectrometry analysis of the J. phoenicea essential oil resulted in the identification of 37 compounds, representing 96.98% of the oil; α-Pinene (24.02%), limonene (7.94%), D-3-Carene (16.9%), Germacrene D (11.98%), Germacrene B (5.40%) and δ-cadinene (6.52%) were the major compounds. The IC50 values of essential oil, hexane and methanol extracts against α-amylase were 35.44, 30.15 and 53.76 µg/mL respectively, and those against pancreatic lipase were 66.15, 68.47 and 60.22 µg/mL respectively, suggesting powerful anti-diabetic and anti-obesity effects. Antioxidant activity (IC50=2 µg/mL) and total phenolics content (265 mg as gallic acid equivalent/g extract) of the methanol extract were found to be the highest compared to the other extracts. Conclusions:The findings showed that the extents ofα-amylase and pancreatic lipase inhibitory activities of the J. phoenicea extracts as well as their antioxidant activity are in accordance with total phenolics contents. Leaves of J. phoenicea being rich in phenolics may provide a good source of natural products with interesting medicinal properties.

  15. Anti-obesity effect of Lactobacillus gasseri BNR17 in high-sucrose diet-induced obese mice.

    Directory of Open Access Journals (Sweden)

    Ji-Hee Kang

    Full Text Available Previously, we reported that Lactobacillus gasseri BNR17 (BNR17, a probiotic strain isolated from human breast milk, inhibited increases in body weight and adipocyte tissue weight in high-sucrose diet-fed Sprague-Dawley (SD rats and reduced glucose levels in type 2 diabetes mice. In the current study, we conducted further experiments to extend these observations and elucidate the mechanism involved. C57BL/6J mice received a normal diet, high-sucrose diet or high-sucrose diet containing L. gasseri BNR17 (10(9 or 10(10 CFU for 10 weeks. The administration of L. gasseri BNR17 significantly reduced the body weight and white adipose tissue weight regardless of the dose administered. In BNR17-fed groups, mRNA levels of fatty acid oxidation-related genes (ACO, CPT1, PPARα, PPARδ were significantly higher and those of fatty acid synthesis-related genes (SREBP-1c, ACC were lower compared to the high-sucrose-diet group. The expression of GLUT4, main glucose transporter-4, was elevated in BNR17-fed groups. L. gasseri BNR17 also reduced the levels of leptin and insulin in serum. These results suggest that the anti-obesity actions of L. gasseri BNR17 can be attributed to elevated expression of fatty acid oxidation-related genes and reduced levels of leptin. Additionally, data suggested the anti-diabetes activity of L. gasseri BNR17 may be to due elevated GLUT4 and reduced insulin levels.

  16. Clogging the enrichment bypass

    International Nuclear Information System (INIS)

    The issue that has come to be known as the bypass is the latest dispute in the continuing saga of uranium trade between the United States and the Commonwealth of Indepenent States. Bypass deals now being conducted by US utilities have drawn heavy criticism from the US Department of Commerce but are perfectly legal under the terms of the Suspension Agreements. Urged on by the United States Enrichment Corporation, the US DOC intends to stop, or at least severely restrict, bypass deals. Using a recent agreement with Kazakhstan as a case study, this article reviews the implications of such bypass deals

  17. Effect of postoperative care of the laparoscopic Roux - en - Y gastric bypass surgery in patients with type 2 di-abetes%腹腔镜胃旁路手术治疗2型糖尿病术后长效护理效果研究

    Institute of Scientific and Technical Information of China (English)

    方方; 徐亚香; 刘楠; 王道荣

    2015-01-01

    目的:探讨腹腔镜下胃旁路手术治疗Ⅱ型糖尿病患者的术后护理效果。方法:将34例行腹腔镜胃旁路手术治疗Ⅱ型糖尿病的患者随机分成试验组和对照组,比较两组患者术后第1周、15天、1个月、2个月、3个月的餐后两小时血糖及术后3个月的糖化血红蛋白、体重指数。结果:试验组患者术后各时间点血糖、糖化血红蛋白、体重指数(BMI)恢复优于对照组;患者满意度、健康教育效果得到认可和提高。结论:手术治疗糖尿病效果显著,同时有效的术后护理干预能优化手术治疗Ⅱ型糖尿病的效果,促进Ⅱ型糖尿病的恢复,减少并发症。%Objective To explore the effect of postoperative care of the laparoscopic Roux - en - Y gastric bypass surgery in patients with type 2 diabetes. Method 34 cases of laparoscopic mini - gastric bypass in the treatment of type 2 diabetes were randomly into experi-mental group and control group,two groups were compared postoperative 1 week,1 month,2 months,3 months,fasting glucose,two - hour postprandial blood glucose,glycosylated hemoglobin,body mass index. Results The patients blood glucose,glycosylated hemqoglobin,body mass index(BMI)was better than the control group recovered at each time point;patient satisfaction,health education to be recognized and enhanced. Conclusion Surgical treatment of diabetes has significant effect. Effective nursing intervention can optimize postoperative surgical treatment of type 2 diabetes,and promote the recovery and reduce complications.

  18. Early marginal ulcer following Roux-en-Y gastric bypass under proton pump inhibitor treatment: prospective multicentric study Úlcera perianastomótica após derivação gástrica em Y-de-Roux mesmo em uso de inibidor de bomba de prótons: estudo prospectivo multicêntrico

    Directory of Open Access Journals (Sweden)

    Arthur Belarmino Garrido Jr.

    2010-06-01

    Full Text Available CONTEXT: Causal factors of gastrojejunal ulcers after Roux-en-Y gastric bypass include peptic acid secretion from the gastric pouch. Esomeprazole is a potent inhibitor of acid secretion. OBJECTIVE: To assess the occurrence of dyspepsia and gastrojejunal ulcers within the first 2 months after Roux-en-Y gastric bypass during the use of esomeprazole. METHODS: One hundred eighteen morbid obese subjects were submitted to Roux-en-Y gastric bypass. Preoperative upper gastrointestinal tract endoscopy was negative for H. pylori. All subjects received esomeprazole for 60 days after surgery. RESULTS: Two weeks after surgery only 13 mild symptoms were reported. After 2 months, 17 also moderate complaints were registered. Endoscopy around the 60th day showed esophagitis in 10 (8.5%, hiatal hernia in 2 (1.7%, foreign body in the anastomotic line in 12 (10.2% and gastrojejunal ulcers was observed in 9 (7.6% subjects, 2 of which had a suture material or metallic staple granuloma in the gastrojejunostomy. Ten subjects took nonsteroidal anti-inflammatory drugs at least once during study, but none of them developed ulcer. None of the subjects with ulcer had dyspeptic symptoms. CONCLUSION: The incidence of ulcer in the gastrojejunal anastomosis within the first 2 months following Rouxen-Y gastric bypass under proton pump inhibitors is considerable. It was not related to the use of non-steroidal anti-inflammatory drugs, highlighting the possibility of ischemia and foreign body as causal factors. The ulcers were asymptomatic, and all post-surgical dyspeptic symptoms were moderate in severity.CONTEXTO: Sintomas dispépticos são comuns após derivação gástrica em Y-de-Roux. Podem decorrer de úlceras de boca anastomótica, cujos possíveis fatores causais incluem a secreção cloridropéptica da bolsa gástrica, isquemia, efeito de corpo estranho dos materiais de sutura e uso de antiinflamatórios não-esteróides. O esomeprazol é um redutor potente da secre

  19. Estudo da gastrinemia pré e pós-operatória em pacientes submetidos à gastroplastia vertical com banda e reconstrução em Y de Roux por obesidade mórbida The behaviour of pre and post operative gastrinemia in patients submitted to vertical banded gastroplasty with Roux-em-Y gastric bypass for morbid obesity

    Directory of Open Access Journals (Sweden)

    Edmundo Anderi Jr

    2008-12-01

    for the treatment of morbid obesity. Key-words: morbid obesity*, gastric bypass*, gastrin*.

  20. Evaluation of Anti-obesity Effects of Aqueous and Ethanolic Extracts of Pomegranate Fruit Peel Using Anthropometrical Indices in Male Wistar Rats

    Directory of Open Access Journals (Sweden)

    Mohammad Hassanpour fard

    2015-04-01

    Results: Comparison of weight change before and after the intervention showed a significant reduction in the Group E and a significant increase in group N (p≤0.05. Waist circumference was significantly increased in the experimental group A and control group N (p≤0.05 and reduced in group X (p≤0.05.There was no significant difference in plasma lipid profile between the groups. Conclusion: The ethanolic extract of pomegranate fruit peel can be considered as an anti-obesity compound in further studies.

  1. Apolipoprotein A-I possesses an anti-obesity effect associated with increase of energy expenditure and up-regulation of UCP1 in brown fat

    OpenAIRE

    Ruan, Xiangbo; Li, Zhenghu; Zhang, Yixuan; Yang, Ling; Pan, Yi; Wang, Zhenzhen; Feng, Gen-Sheng; Chen, Yan

    2010-01-01

    Abstract Apolipoprotein A-I (ApoA-I) is the most abundant protein constituent of high-density lipoprotein (HDL). Reduced plasma HDL and ApoA-I levels have been found to be associated with obesity and metabolic syndrome in human beings. However, whether or not ApoA-I has a direct effect on obesity is largely unknown. Here we analysed the anti-obesity effect of ApoA-I using two mouse models, a transgenic mouse with overexpression of ApoA-I and the mice administered with an ApoA-I mimetic peptid...

  2. Oral administration of O-2 lean, an anti-obesity herbal composition increased 5-HT metabolism, decreased food intake and body weight in overweight rats

    International Nuclear Information System (INIS)

    Feeding behavior is complex processes controlled by the neruroendocrine system.5-HT play an important role in regulation of energy balance by suppressing food intake. Depletion of brain serotonin increase feeding behavior and develop obesity. Many serotoninergic compounds are available in market for the management of body weight. 02-Lean is an anti-obesity herbal formulation prepared by combination of different herbs. Oral administration of aqueous suspension of 02-Lean caused a significant decrease in body weight, food intake, and increase in whole brain 5-HT 5HIAA, tryptophan and plasma tryptophan in over weight rats treated with 0.096g/2ml 02-Lean in comparison to control group. (author)

  3. Ethnobotanical Study of Medicinal Plants Used as Anti-Obesity Remedies in the Nomad and Hunter Communities of Burkina Faso

    Directory of Open Access Journals (Sweden)

    Dramane Pare

    2016-04-01

    Full Text Available Background: Obesity is a global epidemic that affects both developed and developing countries. According to World Health Organization (WHO, in 2014, over 1.9 billion adults were overweight. Burkina Faso, like other countries, faces the problem of obesity, with a prevalence of 7.3%. The main cause is excessive intake of caloric foods combined with low physical activity, although genetic, endocrine and environmental influences (pollution can sometimes be predisposing factors. This metabolic imbalance often leads to multiple pathologies (heart failure, Type II diabetes, cancers, etc.. Drugs have been developed for the treatment of these diseases; but in addition to having many side effects, locally these products are not economically accessible to the majority of the population. Burkina Faso, like the other countries bordering the Sahara, has often been confronted in the past with periods of famine during which populations have generally used anorectic plants to regulate their food needs. This traditional ethnobotanical knowledge has not been previously investigated. An ethnobotanical survey was conducted in Burkina Faso in the provinces of Seno (North and Nayala (Northwest to list the plants used by local people as an anorectic and/or fort weight loss. Methods: The survey, conducted in the two provinces concerned traditional healers, herbalists, hunters, nomads and resourceful people with knowledge of plants. It was conducted over a period of two months and data were collected following a structured interview with the respondents. The approach was based on dialogue in the language of choice of the respondent and the use of a questionnaire. The data have been structured and then statistically analyzed. Results: The fifty-five (55 respondents of the survey were aged between 40 and 80 years. Sixty-one (61 plant species, belonging to thirty-one (31 families were listed as appetite suppressants and/or for their anti-obesity properties. The main

  4. Preformulation characterization and in vivo absorption in beagle dogs of JFD, a novel anti-obesity drug for oral delivery.

    Science.gov (United States)

    Fan, Yunzhou; Yang, Meiyan; Wang, Yuli; Li, Yanyou; Zhou, Yuanda; Chen, Xiaoping; Shan, Li; Wei, Jun; Gao, Chunsheng

    2015-05-01

    JFD (N-isoleucyl-4-methyl-1,1-cyclopropyl-1-(4-chlorine)phenyl-2-amylamine·HCl) is a novel investigational anti-obesity drug without obvious cardiotoxicity. The objective of this study was to characterize the key physicochemical properties of JFD, including solution-state characterization (ionization constant, partition coefficient, aqueous and pH-solubility profile), solid-state characterization (particle size, thermal analysis, crystallinity and hygroscopicity) and drug-excipient chemical compatibility. A supporting in vivo absorption study was also carried out in beagle dogs. JFD bulk powders are prismatic crystals with a low degree of crystallinity, particle sizes of which are within 2-10 μm. JFD is highly hygroscopic, easily deliquesces to an amorphous glass solid and changes subsequently to another crystal form under an elevated moisture/temperature condition. Similar physical instability was also observed in real-time CheqSol solubility assay. pK(a) (7.49 ± 0.01), log P (5.10 ± 0.02) and intrinsic solubility (S0) (1.75 μg/ml) at 37 °C of JFD were obtained using potentiometric titration method. Based on these solution-state properties, JFD was estimated to be classified as BCS II, thus its dissolution rate may be an absorption-limiting step. Moreover, JFD was more chemically compatible with dibasic calcium phosphate, mannitol, hypromellose and colloidal silicon dioxide than with lactose and magnesium stearate. Further, JFD exhibited an acceptable pharmacokinetic profiling in beagle dogs and the pharmacokinetic parameters T(max), C(max), AUC(0-t) and absolute bioavailability were 1.60 ± 0.81 h, 0.78 ± 0.47 μg/ml, 3.77 ± 1.85 μg·h/ml and 52.30 ± 19.39%, respectively. The preformulation characterization provides valuable information for further development of oral administration of JFD. PMID:24694186

  5. Timing of Pregnancy After Gastric Bypass—a National Register-Based Cohort Study

    DEFF Research Database (Denmark)

    Kjær, Mette Karie Mandrup; Nilas, Lisbeth

    2013-01-01

    Current recommendations suggest postponing pregnancy by at least 1 year after gastric bypass. During the first postoperative year, women are in a catabolic phase with a rapid weight loss which may increase the risk of adverse pregnancy and neonatal outcomes. This study tested the hypothesis that...... the risk of adverse pregnancy and neonatal outcomes is increased in women who conceive during the first year after gastric bypass surgery....

  6. The anti-obesity effects of the dietary combination of fermented red ginseng with levan in high fat diet mouse model.

    Science.gov (United States)

    Oh, Jin sun; Lee, Seung Ri; Hwang, Keum Taek; Ji, Geun Eog

    2014-04-01

    In this study, to evaluate the anti-obesity effects of fermented red ginseng (FG), levan (L), and their combination (FGL), we investigated their effects on the weights of body, liver and white adipose tissue, lipid profiles, and biomarkers for insulin resistance in high fat diet (HFD)-induced obese C57BL/6J male mice. Furthermore, the levels of leptin in the serum were measured. FG (150 mg/kg/d), L (100 mg/kg/d), and FGL (150 mg/kg/d of FG plus 100 mg/kg/d of L) were administered orally to mice daily for 11 weeks. After 11 weeks feeding, FGL showed significantly lower body weight and fat mass with decreasing food efficiency ratio than the HFD control mice. In addition, the FGL group was significantly lower in the levels of total cholesterol and fasting blood glucose and score of the homeostatic model assessment of insulin resistance. Furthermore, FGL decreased serum leptin levels compared to the HFD control group. Taken together, FGL showed a significant anti-obesity effect in HFD-induced obese mice and prevent insulin and leptin resistance. FGL may be potentially useful for the prevention of obesity. PMID:23873605

  7. Anti-Obesity and Hypoglycemic Effects of Poncirus trifoliata L. Extracts in High-Fat Diet C57BL/6 Mice

    Directory of Open Access Journals (Sweden)

    Sheng Jia

    2016-04-01

    Full Text Available The present study investigated the possible anti-obesity and hypoglycemic effects of Poncirus trifoliata L. extracts. Mature fruit were divided into flavedo (PF and juice sacs (PJ, and extracts from them were tested on C57BL/6 mice fed a high-fat diet (HFD for thirteen weeks. Both fruit extracts (40 mg/kg body weight, respectively showed anti-obesity and hypoglycemic effects. Consumption of PF and PJ extracts reduced body weight by 9.21% and 20.27%, respectively. Liver and adipose weights, fasting glucose, serum triglyceride (TG, and low density lipoprotein cholesterol (LDL-c levels decreased significantly, while serum high density lipoprotein cholesterol (HDL-c and oral glucose tolerance levels increased significantly in response to two fruit extracts. These effects were due in part to the modulation of serum insulin, leptin, and adiponectin. Furthermore, transcript levels of fatty acid synthase (FAS and stearoyl-CoA desaturase 1 (SCD1 were reduced while those of carnitine palmitoyltransferase 1α (CPT1α and insulin receptor substrate 2 (IRS2 were increased in the liver of C57BL/6 mice, which might be an important mechanism affecting lipid and glucose metabolism. Taken together, P. trifoliata fruit can be potentially used to prevent or treat obesity and associated metabolic disorders.

  8. Bypassing damaged nervous tissue

    CERN Document Server

    Shneider, M N

    2016-01-01

    We show the principal ability of bypassing damaged demyelinated portions of nervous tissue, thereby restoring its normal function for the passage of action potentials. We carry out a theoretical analysis on the basis of the synchronization mechanism of action potential propagation along a bundle of neurons, proposed recently in [1]. And we discuss the feasibility of implement a bypass to restore damaged nervous tissue and creating an artificial neuron network.

  9. Gastric partitioning gastrojejunostomy in unresectable distal gastric cancer patients.

    Science.gov (United States)

    Kwon, Sung Joon; Lee, Ha Gyoon

    2004-04-01

    The main purpose of bypass surgery in patients with unresectable distal gastric cancer is to improve their quality of life (QoL). However, the result of conventional gastroenterostomy is dismal including continuous bleeding due to the contact of food material on the tumor surface and early obstruction of the stoma by tumor growth. Developing more effective surgery is warranted to improve the QoL of these patients. Among the 1158 patients with gastric cancer who underwent surgery from March 1993 to July 2002 at Hanyang University Medical Center, 54 (4.7%) had unresectable cancers. Various types of gastrojejunostomy (G-Jstomy), including conventional G-Jstomy (CGJ) (n = 18), antral exclusion G-Jstomy (n = 7), and gastric partitioning G-Jstomy (GPGJ) (n = 17), as well as exploratory laparotomy only (n = 12) were performed in these unresectable cases. In this study, survival and postoperative QoL were compared for the CGJ and GPGJ groups. The median survivals were 120 and 209 days for the CGJ and GPGJ groups, respectively (p = 0.046). The rates of postoperative body weight loss compared to the preoperative weight were 9.3% and 3.1% in the CGJ and GPGJ groups, respectively; the difference showed borderline significance (p = 0.067). The volume of blood transfusion was much less during the postoperative period than during the preoperative period in the GPGJ group but not in the CGJ group. The GPGJ procedure minimized food contact on the tumor surface, which was confirmed by an upper gastrointestinal barium meal series. GPGJ can be recommended as the procedure of choice for bypass surgery in patients with unresectable distal gastric cancer considering their improved survival and postoperative QoL compared to those who underwent CGJ. PMID:14994143

  10. Gastric culture

    Science.gov (United States)

    ... test or procedure preparation (3 to 6 years) School age test or procedure preparation (6 to 12 ... immune system. The final results of the gastric culture test may take several weeks. Your provider will ...

  11. Gastric Banding

    Science.gov (United States)

    ... gastric banding before deciding to have the procedure. Advertisements for a device or procedure may not include ... feeds Follow FDA on Twitter Follow FDA on Facebook View FDA videos on YouTube View FDA photos ...

  12. Obstrução intestinal pós-gastroplastia redutora pela técnica de higa para tratamento da obesidade mórbida: aspectos por imagem Intestinal obstruction after Roux-en-Y gastric bypass by Higa's technique for treatment of morbid obesity: radiological aspects

    Directory of Open Access Journals (Sweden)

    Ester Moraes Labrunie

    2007-06-01

    Full Text Available OBJETIVO: O objetivo deste estudo foi descrever os principais aspectos radiológicos encontrados nas obstruções intestinais pós-operatórias em pacientes submetidos a derivação gastrintestinal em Y de Roux pela técnica de Higa. MATERIAIS E MÉTODOS: Foram estudados 10 pacientes com obstrução intestinal no pós-operatório de gastroplastia redutora, examinados entre novembro de 2001 e abril de 2006. Os casos foram obtidos em sete instituições hospitalares distintas. RESULTADOS: Nos 10 pacientes, a obstrução ocorreu em alça de delgado, sendo cinco por hérnia interna, três por brida, um por hérnia umbilical e um por intussuscepção gástrica. Em quatro pacientes a obstrução ocorreu precocemente (até o sétimo dia de pós-operatório e em seis aconteceu tardiamente (entre o terceiro mês e cinco anos de pós-operatório. CONCLUSÃO: Todos os casos de obstrução intestinal ocorreram ao nível do intestino delgado. A hérnia interna foi a causa mais freqüente, seguida de brida. Outras causas foram hérnia umbilical e intussuscepção gástrica.OBJECTIVE: The aim of this study is to describe the main radiological aspects of postoperative intestinal obstruction in patients submitted to Roux-en-Y gastric bypass by means of the Higa's technique. MATERIALS AND METHODS: A total of 10 patients presenting with postoperative intestinal obstruction following a gastric reduction procedure were evaluated in the period between November 2001 and April 2006, in seven different medical centers. RESULTS: In the ten patients, the obstruction occurred in the small bowel, five of them because of internal hernias, three because of adhesions, one because of an umbilical hernia and one because of intussusception. Four patients presented obstruction early in the postoperative period (by the seventh post-op day, and six, late in the postoperative period (between the third month and the fifth year. CONCLUSION: All of the cases of intestinal obstruction

  13. Fístulas de anastomose superior pós-gastroplastia redutora pela técnica de Higa para tratamento da obesidade mórbida: aspectos por imagem Anastomotic leaks after Roux-en-Y gastric bypass surgery by Higa's technique for treatment of morbid obesity: radiological findings

    Directory of Open Access Journals (Sweden)

    Ester Moraes Labrunie

    2008-04-01

    Full Text Available OBJETIVO: Descrever os principais aspectos radiológicos encontrados nas fístulas pós-operatórias de anastomose superior em pacientes submetidos a derivação gastrintestinal em Y de Roux pela técnica de Higa. MATERIAIS E MÉTODOS: Foram estudados 24 pacientes com fístula de anastomose no pós-operatório de gastroplastia redutora, avaliados por tomografias computadorizadas e/ou seriografias esofagogastrojejunais. RESULTADOS: As fístulas de anastomose superior ocorreram até o 30º dia de pós-operatório. Dezenove pacientes realizaram exame radiológico no momento do diagnóstico, sendo observado extravasamento de contraste, considerado sinal direto de fístula de anastomose, em dez pacientes. Dos nove restantes, em sete foi evidenciado extravasamento em exames subseqüentes, sendo ainda identificados sinais indiretos de fístula em seis destes. Sinais indiretos foram observados também em pacientes com extravasamento de contraste nos exames iniciais, sendo o pneumoperitônio o aspecto mais freqüente. Dos cinco pacientes sem exame radiológico no momento do diagnóstico, exames subseqüentes evidenciaram extravasamento de contraste em um e sinais indiretos em quatro pacientes. CONCLUSÃO: O achado radiológico mais comum foi o extravasamento de contraste (sinal direto de fístula. Os sinais indiretos foram: nível líquido bizarro, coleção intracavitária, pneumoperitônio desproporcional ao tempo pós-operatório, líquido na cavidade peritoneal, edema da anastomose inferior e distensão de delgado.OBJECTIVE: The present study was aimed at describing main radiological findings in patients who developed leaks as a complication of Roux-en-Y gastric bypass surgery by the Higa's technique. MATERIALS AND METHODS: Twenty-four patients with post-gastric bypass anastomotic leaks were evaluated by means of computed tomography or gastrointestinal series. RESULTS: Leaks of superior anastomoses generally occurred within 30 postoperative days

  14. Uso da mirtazapina no tratamento da náusea e vômito refratários a terapia habitual após derivação gástrica em Y de Roux Intractable nausea and vomiting following Roux-en-Y gastric bypass controlled with mirtazapine

    Directory of Open Access Journals (Sweden)

    Alexandre Coutinho Teixeira de Freitas

    2008-03-01

    Full Text Available RACIONAL: A cirurgia bariátrica é procedimento com significativa morbidade. A náusea a vômito geralmente ocorrem devido à presença de complicações mecânicas como as estenoses das anastomoses. Alguns casos apresentam sintomas importantes na ausência dessas complicações. OBJETIVO: Relato do uso da mirtazapina no pós-operatório de cirurgia bariátrica em um paciente com náuseas de vômitos refratários ao tratamento clínico habitual, na ausência de complicações mecânicas. RELATO DO CASO: Paciente portador de obesidade mórbida foi submetido à derivação gástrica em Y de Roux laparoscópica. Evoluiu com náusea persistente associada a episódios de vômitos refratários a ondansetron, metoclopramida e bromoprida. Não foram identificadas causas mecânicas para o quadro. Foi iniciado mirtazapina (Remeron® via oral na dose de 30mg por dia durante 60 dias. Após dois dias do início da medicação foi observado melhora total do quadro. A mirtazapina é um antidepressivo que apresenta efeito antiemético através do bloqueio de receptores para a serotonina (5-HT3 no centro do vômito no tronco cerebral. CONCLUSÃO: A mirtazapina pode ser útil nos casos de náusea e vômito refratários à terapia antiemética habitual no pós-operatório de derivação gástrica em Y de Roux, quando causas mecânicas são excluídas.BACKGROUND: Bariatric surgery is related to significant morbidity. Mechanical complications such as stricture of the anastomotic sites are the most common causes of persistent nausea and vomiting. Some patients present such symptoms in the absence of these complications. AIM: To report the use of mirtazapine in a patient submitted to bariatric surgery, presenting persistent nausea and vomiting in the absence of mechanical complications, and unresponsive to conventional antiemetic drugs. CASE REPORT: A morbidly obese patient submitted to laparoscopic Roux-en-Y gastric bypass presented persistent nausea and vomiting

  15. Application of positive psychology for individualized nursing in type 2 diabetes mellitus patients with gastric bypass%积极心理学在2型糖尿病胃转流术患者个体化护理中的应用

    Institute of Scientific and Technical Information of China (English)

    张敏; 聂雷霞; 张海霞; 李威; 杜艳玲

    2014-01-01

    目的:探讨以积极心理学为基础的个体化护理在2型糖尿病胃转流术患者中的应用效果。方法将2012年6月-2013年6月收治的38例行胃转流术的2型糖尿病患者采用随机数字表法分为对照组18例和干预组20例,对照组采用传统护理干预,干预组实施以积极心理学为基础的个体化护理干预,对两组患者干预前后心理状态、知识掌握及满意度进行评定。结果干预后,两组患者乐观指数、幸福指数、护患信任度均有所提高,且干预组明显高于对照组,差异有统计学意义( P<0.05)。干预组患者对疾病知识掌握程度(28.20±1.96)分和满意度(3.80±0.41)分均高于对照组的(24.94±2.51),(3.39±0.78)分,差异有统计学意义(t分别为4.479,2.068;P<0.05)。结论以积极心理学为基础的个体化护理干预,可改善2型糖尿病胃转流术患者心理健康水平,提高患者知识掌握程度和满意度,对疾病恢复有积极的作用。%Objective To explore the effect of individualized nursing based on positive psychology in the type 2 diabetes mellitus patients with gastric bypass .Methods Thirty-eight cases of type 2 diabetes mellitus patients from June 2012 to June 2013 were randomly divided into the control group ( eighteen cases ) and the intervention group ( twenty cases ) .The control group received the traditional methods of nursing , while the intervention group received individualized nursing based on positive psychology .The patients of the two groups were assessed in the mental status , knowledge and satisfaction .Results After the intervention , both the two groups of patients with optimism , happiness , nurse-patient confidence , the degree of understanding and satisfaction were improved ,the intervention group was significantly higher than that in the control group ( P<0.05).Mastery of the knowledge of the disease (28.20 ±1.96) and

  16. Bypass Flow Study

    International Nuclear Information System (INIS)

    The purpose of the fluid dynamics experiments in the MIR (Matched Index of-Refraction) flow system at Idaho National Laboratory (INL) is to develop benchmark databases for the assessment of Computational Fluid Dynamics (CFD) solutions of the momentum equations, scalar mixing, and turbulence models for the flow ratios between coolant channels and bypass gaps in the interstitial regions of typical prismatic standard fuel element (SFE) or upper reflector block geometries of typical Modular High-temperature Gas-cooled Reactors (MHTGR) in the limiting case of negligible buoyancy and constant fluid properties. The experiments use Particle Image Velocimetry (PIV) to measure the velocity fields that will populate the bypass flow study database.

  17. Bypass Flow Study

    Energy Technology Data Exchange (ETDEWEB)

    Richard Schultz

    2011-09-01

    The purpose of the fluid dynamics experiments in the MIR (Matched Index of-Refraction) flow system at Idaho National Laboratory (INL) is to develop benchmark databases for the assessment of Computational Fluid Dynamics (CFD) solutions of the momentum equations, scalar mixing, and turbulence models for the flow ratios between coolant channels and bypass gaps in the interstitial regions of typical prismatic standard fuel element (SFE) or upper reflector block geometries of typical Modular High-temperature Gas-cooled Reactors (MHTGR) in the limiting case of negligible buoyancy and constant fluid properties. The experiments use Particle Image Velocimetry (PIV) to measure the velocity fields that will populate the bypass flow study database.

  18. The Best Bypass Surgery Trial

    DEFF Research Database (Denmark)

    Møller, Christian H; Jensen, Birte Østergaard; Gluud, Christian; Perko, Mario J; Lund, Jens T; Andersen, Lars Willy; Madsen, Jan Kyst; Hughes, Pia; Steinbrüchel, Daniel A

    2007-01-01

    Recent trials suggest that off-pump coronary artery bypass grafting (OPCAB) reduces the risk of mortality and morbidity compared with conventional coronary artery bypass grafting (CCAB) using cardiopulmonary bypass. Patients with a moderate- to high-risk of complications after CCAB may have addit...

  19. Cardiopulmonary bypass in pregnancy.

    Science.gov (United States)

    Pomini, F; Mercogliano, D; Cavalletti, C; Caruso, A; Pomini, P

    1996-01-01

    The cardiopathic patient can sustain acute heart failure during pregnancy. In such cases, if open heart operation is necessary to save the patient's life, the fetus could be seriously compromised after exposure to cardiopulmonary bypass. From 1958 to 1992, 69 reports of cardiac operations during pregnancy with the aid of cardiopulmonary bypass have been published. Maternal mortality was 2.9%. Embryofetal mortality was 20.2%. Examining only the last 40 patients, maternal and embryofetal mortality were 0.0% and 12.5%, respectively. Embryofetal mortality was 24.0% when hypothermia was used, compared with 0.0% while operating in normothermia. Maternal mortality did not change. The use of hypothermia during cardiopulmonary bypass provoked uterine contractions in several patients. Hypothermia decreases O2 exchange through the placenta. Pump flow and mean arterial pressure during cardiopulmonary bypass seem to be the most important parameters that influence fetal oxygenation. We speculate that cardiac operation is not a contraindication to pregnancy prolongation. PMID:8561577

  20. Aortic valve bypass

    DEFF Research Database (Denmark)

    Lund, Jens T; Jensen, Maiken Brit; Arendrup, Henrik; Ihlemann, Nikolaj

    2013-01-01

    In aortic valve bypass (AVB) a valve-containing conduit is connecting the apex of the left ventricle to the descending aorta. Candidates are patients with symptomatic aortic valve stenosis rejected for conventional aortic valve replacement (AVR) or transcatheter aortic valve implantation (TAVI...

  1. Bypassing AMPK Phosphorylation

    OpenAIRE

    Viollet, Benoit; Foretz, Marc; Schlattner, Uwe

    2014-01-01

    AMP-activated protein kinase (AMPK) functions as a signaling hub to balance energy supply with demand. Phosphorylation of activation loop Thr172 has been considered as an essential step in AMPK activation. In this issue of Chemistry & Biology, Scott and colleagues show that the small molecule direct AMPK activator, A-769662, bypasses this phosphorylation event, and acts synergistically with AMP on naive AMPK.

  2. Endoscopic and ultrasonographic evaluation before and after Roux-en-Y gastric bypass for morbid obesity Avaliação endoscópica e ultra-sonográfica antes e depois de gastroplastia com derivação intestinal em Y-de-Roux para obesidade mórbida

    Directory of Open Access Journals (Sweden)

    Marcelo Passos Teivelis

    2007-03-01

    Full Text Available BACKGROUND: Esophagogastric abnormalities are recognized prior and after bariatric procedures, but frequency and severity are debated. Liver and biliary tract findings are also of clinical importance, especially gallstones and liver steatosis. AIM: To compare pre-operative findings of hepatobiliary ultrasound and upper digestive endoscopy with post-operative results in patients submitted to open Roux-en-Y gastric bypass for morbid obesity. METHODS: A total of 80 patients were enrolled 16.8 ± 12.1 months after operation, all of them on routine follow-up program, and 8 were excluded. Retrospective analysis aimed at pre-operative clinical, endoscopic and ultrasonographic examinations and were prospectively repeated. RESULTS: Pre-operative endoscopical report was available in 42 cases, and 52 examinations were performed post-operatively. Frequency of esophagitis changed from 16.7% (7/42 to 15.4% (8/52, and of gastritis from 45.2% (19/42 to 21.2% (11/52. Gastric or gastrojejunal ulcers were initially present in 4.8% (2/42 and increased to 9.6% (5/52. Post-operatively, an unusual abnormality was silastic band erosion: 7.7% (4/52. Helicobacter pylori was present in 50.0% (21/42 before and 3.5% (2/52 after operation. Ultrasonographic study had been done before intervention in 63 subjects, and 57 were executed on follow-up. Liver steatosis occurred previously in 58.7% (37/63 and in 43.9% (25/57 later on. Only 12.7% (8/63 of the patients had undergone cholecystectomy before bariatric operation, 29.1%(16/55 suffered simultaneous resection of gallbladder because of stones during Roux-en-Y gastric bypass, and an additional 26.8% (10/36 developed gallstones post-operatively. CONCLUSIONS: Liver steatosis did not statistically improve, nor did inflammatory conditions of the upper digestive tube, despite reduction of H. pylori infections; gallbladder stones requiring intervention were common.RACIONAL: Anormalidades esôfago-gástricas são reconhecidas

  3. [Gastric Acid].

    Science.gov (United States)

    Ruíz Chávez, R

    1996-01-01

    Gastric acid, a product of parietal cells secretion, full fills multiple biological roles which are absolutely necessary to keep corporal homeostasis. The production of the acid depends upon an effector cellular process represented in the first step by histamine, acetilcholine and gastrin, first messengers of the process. These interact with specific receptors than in sequence activate second messengers -cAMP and the calcium-calmodulin system- which afterwards activate a kinase. An specific protein is then phosphorilated by this enzyme, being the crucial factor that starts the production of acid. Finally, a proton bomb, extrudes the acid towards the gastric lumen. The secretion process mentioned above, is progressive lyactivated in three steps, two of which are stimulators -cephalic and gastric phases- and the other one inhibitor or intestinal phase. These stages are started by mental and neurological phenomena -thought, sight, smell or memory-; by food, drugs or other ingested substances; and by products of digestion. Changes in regulation of acid secretion, in the structure of gastro-duodenal mucosal barrier by a wide spectrum of factors and agents including food, drugs and H. pylori, are the basis of acid-peptic disease, entity in which gastric acid plays a fundamental role. From the therapeutic point of view, so at the theoretical as at the practical levels, t is possible to interfere with the secretion of acid by neutralization of some of the steps of the effector cellular process. An adequate knowledge of the basics related to gastric acid, allows to create strategies for the clinical handling of associated pathology, specifically in relation to peptic acid disease in all of the known clinical forms. PMID:12165790

  4. Efficiency Biliopancreatic bypass surgery in bulimia nervosa

    Directory of Open Access Journals (Sweden)

    Yu I Yashkov

    2008-06-01

    Full Text Available A clinical significance in the treatment of bulimia nervosa patients with morbid obesity had already been raised [10, 13], but we did not find publications on the effectiveness of bariatric surgery in these cases. There is also information about the possibility of applying the operation bilio-pancreatic bypass, effective in patients with morbid obesity with uncontrolled eating behavior for the treatment of patients with anorexia BILIM not suffering from morbid obesity. In this article the data of clinical observation of a small sample of patients. As a result, the treatment of these patients found that severe nervous BILIM can be seen as a latent form of morbid obesity. The choice of treatment should depend not only on the initial body weight of the patient, but also on the severity of the nervous BILIM. Unsuccessful attempts at organized-balanced, conservative treatment of patients with severe bulimia nervosa may be considered a variant of surgical treatment, while bilio-pancreatic bypass surgery is considered as the most preferred operation, compared with the installation of the gastric balloon and others. All candidates for surgical treatment of obesity must identify clinical signs of bulimia nervosa, as this may influence the choice of method of operation. Further study of the role of hyperinsulinemia, secretion of ghrelin, leptin, intestinal peptide may contribute to the elucidation of the true causes of bulimia nervosa, probably has a similar origin with morbid obesity.

  5. 胃旁路术对2型糖尿病大鼠脂肪组织胰岛素受体β及胰岛素受体底物-1表达的影响%Effect of gastric bypass operation on expressions of adipic insulin receptor and insulin receptor substrate-1 in rats with type 2 diabetes mellitus

    Institute of Scientific and Technical Information of China (English)

    徐键; 林杉; 尹家俊

    2015-01-01

    Objective To investigate the expressions of adipic insulin receptor β (IR-β) and insulin receptor substrate-1 (IRS-1) after gastric bypass (GBP) operation in spontaneous rats with type 2 diabetes mellitus (GK rats) and to elucidate the mechanisms of GBP in improving insulin resistance. Methods Thirty male GK rats aged 8 weeks were randomly divided into 3 groups according to the table of random number:the operation group (GBP, 10 rats), the sham operation group (the same sites were cut off as GBP and end to end anastomosis was performed in site, 10 rats) and the diet pairing group (the same kind and weight dieting as the operation group, 10 rats), besides 10 male SD rats aged 8 weeks were used as blank control group (free eating and drinking). Four weeks before and after operation, levels of fasting blood glucose (FPG) and fasting insulin (FINS) were measured, HOMA-IR was calculated respectively, and compared among 4 groups. Then rats were decapitated to retrieve the omentum. Expressions of adipic IR-βand IRS-1 protein were detected by Western blot. Results Compared with the preoperative levels, the FPG and HOMA-IR decreased significantly 4 weeks after surgery in operation group [(5.13±0.22) vs. (11.73±0.37) mmol/L, 2.16± 0.18 vs. 5.10±0.29, P0.05). FINS showed no obvious change in these 4 groups after operation(all P>0.05). Expressions of IR-β and IRS-1 were significantly higher in operation group than those in other 3 groups 4 weeks after the operation (all P0.05);而假手术组和饮食配对组较术前无显著变化(均P>0.05);术后4周手术组IR-β及IRS-1表达量均明显高于其他3组(均P<0.05)。结论胃旁路术能上调2型糖尿病大鼠胰岛素信号转导通路中IR-β及IRS-1的表达,改善脂肪组织胰岛素抵抗,提高胰岛素的敏感性。

  6. Relação entre o estado nutricional de vitamina a e a regressão da esteatose hepática após gastroplastia em Y- de- Roux para tratamento da obesidade classe III Relationship of the nutritional status of vitamin a and the regression of hepatic steatosis after Roux-en-Y gastric bypass surgery for treatment of class III obesity

    Directory of Open Access Journals (Sweden)

    Luiz Gustavo de Oliveira e Silva

    2012-12-01

    Full Text Available RACIONAL: A vitamina A participa de várias funções primordiais no organismo humano e as suas concentrações séricas podem estar diminuídas nas doenças crônicas não transmissíveis. OBJETIVO: Avaliar a relação entre o estado nutricional da vitamina A, e a regressão da esteatose hepática em indivíduos submetidos à gastroplastia em Y-de-Roux para tratamento da obesidade classe III. MÉTODOS: Foram estudados 30 pacientes obesos classe III, de ambos os sexos, com esteatose hepática, submetidos à gastroplastia em Y-de-Roux. Seis meses após a operação, os pacientes foram submetidos à ultrassonografia abdominal e distribuídos em dois grupos: grupo 1 - pacientes com esteatose detectada na ultrassonografia e grupo 2 - pacientes sem esteatose detectada na ultrassonografia. No pré-operatório e seis meses após a operação foram realizadas análises antropométricas e exames bioquímicos: insulina basal, glicemia, Homeostasis Model Assessment Index (HOMA IR, colesterol, HDL, LDL, triglicerídeos, AST, ALT, Gama-GT, albumina, bilirrubina total, retinol, e beta caroteno. RESULTADOS: A média de perda de peso foi de 35,05 + 10,47 (pBACKGROUND: Vitamin A participates in several essentials functions in the human body and their serum concentrations may be decreased in non-transmissible diseases. AIM: To assess the relationship of the nutritional status of Vitamin A through the serum concentrations of retinol and beta carotene, with regression of hepatic steatosis in individuals who undergone Roux-en-Y gastric bypass surgery for treatment of class III obesity. METHODS: Were included 30 individuals, male and female, submitted to Roux-en-Y gastric bypass for treatment of class III obesity, who were diagnosed through an abdominal ultrasonography as presenting hepatic steatosis. From the result of an ultrasonography screened six months after the surgical procedure those subjects were divided into two groups: group 1 - patients with steatosis

  7. Axillobifemoral bypass grafting

    Directory of Open Access Journals (Sweden)

    Davidović Lazar B.

    2004-01-01

    Full Text Available INTRODUCTION Axillo-femoral bypass (AxF means connecting the axillar and femoral artery with the graft that is placed subcutaneously [1]. Usually, this graft is connected with contralateral femoral artery via one accessory subcutaneous graft, and this connection is known as axillobifemoral bypass (AxFF. This extra-anatomic procedure is an alternative method to the standard reconstruction of aortoiliac region when there are contraindications for general or local reasons. OBJECTIVE The objective of this paper is to show early and late results of AxFF bypass grafting as well as to show the indications for AxFF bypass. METHODS The sample consisted of 37 patients. The procedure was performed in 28 patients who suffered from aortoiliac occlusive disease and who were at high risk due to the comorbidity- in one patient with the rupture of juxtarenal aneurysm of abdominal aorta; in five patients with aortoenteric fistula, in two patients with iatrogenic lesion of abdominal aorta and in one female patient with anus preternaturalis definitivus who was treated for rectovaginal fistula. Donor's right axillary artery was used in 26 cases (70.3%, and donor's left axillary artery was used in 9 cases (29.7%. Dacron graft was used in 34 patients and Polytetrafluo-roethlylene graft was used in three patients. Simultaneously, profundo-plastic was done in four patients and femoro-popliteal bypass was performed in three patients. In five patients who suffered from aortoenteric fistula, simultaneous intervention of gastrointerstinal system has been done, x2 test was used for statistical evaluation and life table method was used for verification of late graft patency. RESULTS The rate of early postoperative mortality was 13.5%. The causes of death were: sepsis -1, MOFS - 3, and infarct myocardium -1. The mean follow up period was 40.1 months, ranging from six months to 17 years. During the follow up period, an early graft thrombosis was identified in two and late graft

  8. Gastric electrical stimulation for the treatment of obesity: from entrainment to bezoars-a functional review.

    Science.gov (United States)

    Mintchev, Martin P

    2013-01-01

    GROWING WORLDWIDE OBESITY EPIDEMIC HAS PROMPTED THE DEVELOPMENT OF TWO MAIN TREATMENT STREAMS: (a) conservative approaches and (b) invasive techniques. However, only invasive surgical methods have delivered significant and sustainable benefits. Therefore, contemporary research exploration has focused on the development of minimally invasive gastric manipulation methods featuring a safe but reliable and long-term sustainable weight loss effect similar to the one delivered by bariatric surgeries. This antiobesity approach is based on placing external devices in the stomach ranging from electrodes for gastric electrical stimulation to temporary intraluminal bezoars for gastric volume displacement for a predetermined amount of time. The present paper examines the evolution of these techniques from invasively implantable units to completely noninvasive patient-controllable implements, from a functional, rather than from the traditional, parametric point of view. Comparative discussion over the available pilot and clinical studies related to gastric electrical stimulation outlines the promises and the fallacies of this concept as a reliable alternative anti-obesity strategy. PMID:23476793

  9. Effect of gastric bypass surgery on mRNA expression level of hepatic phosphoenolpyruvate carboxykinase in type 2 diabetic Goto-Kakizaki rats%胃旁路术对2型糖尿病大鼠肝脏磷酸烯醇式丙酮酸羧激酶mRNA表达的影响

    Institute of Scientific and Technical Information of China (English)

    谢杰斌; 蔡景理; 李立军; 张林君; 姜明哲; 陈登刚; 陈荣

    2012-01-01

    Objective To investigate the effects of gastric bypass surgery(GBP)on hepatic phosphoenolpyruvate carboxykinase(PEPCK)mRNA expression in type 2 diabetic Goto-Kakizaki rats.Methods Male GK rats were randomized into three groups:gastric bypass surgery(n=10),sham operation with diet restriction(n=10),and sham operation alone(n=10).Liver specimens of GK rats were collected during the intraoperative period for self-control study and 8 weeks after surgery.Fasting blood glucose,food intake,and body weight were recorded before surgery and 1,2,4,8 weeks after surgery.The expression of PEPCK mRNA was measured by real-time PCR.Results The fasting plasma glucose level decreased from(17.6±2.1)mmol/L before surgery to(7.5±0.9)mmol/L 8 weeks after surgery in GBP group.The level of PEPCK mRNA decreased from 1.08±0.38 before surgery to 0.41±0.10 8 weeks after surgery,significantly lower than that in sham operation alone group(1.04±0.12)(P<0.01).The level of PEPCK mRNA in diet restriction group increased from 1.15±0.16 before surgery to 2.54±0.82 8 weeks after surgery(P<0.01).The expression of PEPCK mRNA in diet restriction was significantly higher than that in CBP group(P<0.01).Conclusions GBP can significantly improve hyperglycemia in type 2 diabetic GK rat models,which may be associated with the decrease of hepatic PEPCK mRNA level.%目的 研究胃旁路术对2型糖尿病Goto-Kakizaki(GK)大鼠降糖作用及肝脏磷酸烯醇式丙酮酸羧激酶(PEPCK)mRNA表达的影响.方法 将30只12周龄的雄性GK大鼠分为手术组(胃旁路术,10只)、假手术饮食控制组(10只)及假手术空白对照组(10只),术中取各组肝脏标本用于术后对照研究.观察手术前后空腹血糖、进食量及体质量变化情况.术后8周取各组肝脏标本,用实时荧光定量PCR(real-time PCR)检测各组肝脏手术前后PEPCK mRNA的表达变化.结果 术后8周,手术组空腹血糖由术前(17.6±2.1)mmol/L下降至(7.5±0.9)mmol

  10. Anti-obesity potential of enzymatic fragments of hyaluronan on high-fat diet-induced obesity in C57BL/6 mice.

    Science.gov (United States)

    Park, Byong-Gon; Park, Yoon-Sun; Park, Joo Woong; Shin, Eunji; Shin, Woon-Seob

    2016-04-22

    Hyaluronan has diverse biological activities depending on its molecular size. The hyaluronan fragments (50 kDa) can decrease adipogenic differentiation in vitro. However, in vivo anti-obesitic effects of hyaluronan fragments have not been elucidated. Therefore, we examined the anti-obesity effects of hyaluronan fragments on high-fat diet induced obesity in C57BL/6 mice. Oral administration of hyaluronan fragments (200 mg/kg for 8 weeks) decreased body weight, adipose tissues, serum lipid (low-density lipoprotein cholesterol, triglyceride), and leptin level. Hyaluronan fragments decreased the hypertrophy of adipose tissue and ameliorated liver steatosis. The mRNA expression of leptin was reduced in adipocyte by treatment with hyaluronan fragments. Additionally, hyaluronan fragments enhanced the mRNA expression of PPAR-α and its target genes UCP-2 and decreased mRNA expression of PPAR- γ and fatty acid synthase in liver. In conclusions, hyaluronan fragments had marked effects on inhibiting the development of obesity in obese mice fed the high-fat diet. It suggested that enhancing PPAR-α and suppressing PPAR-γ expression are two possible mechanisms for the anti-obesitic effect of hyaluronan fragments. PMID:27012203

  11. Anti-obesity effect of an isoflavone fatty acid ester on obese mice induced by high fat diet and its potential mechanism

    Directory of Open Access Journals (Sweden)

    Shen Hong

    2010-05-01

    Full Text Available Abstract Background The novel compound 1a is one of the isoflavone fatty acid esters. In order to investigate the anti-obesity effect of compound 1a and its potential mechanism of influence in adipocyte differentiation, Obese male C57BL/6J mice induced by high-fat diet (HFD and rat preadipocytes (3T3-L1 cell were used. Methods After 4-week HFD induction, the obese model was made successfully. After treatment with compound 1a, mice plasma biochemistry parameters were analyzed. In addition, mice hepatic tissue slice was observed. In in vitro research, 3T3-L1 cell differentiation by Oil-Red-O staining and adipocyte apoptosis was detected by flow cytometry. Results The in vivo results implied that compound 1a significantly decreased the body weight, white adipose tissue weight of obesity mice(p in vitro results suggested that compound 1a could significantly suppress the adipocyte viability and lipid accumulation in the differentiation of preadipocyte, and induce apoptosis in both preadipocytes and mature adipocytes(p Conclusion Compound 1a regulates serum lipid profiles, decreases adipose tissue mass and body weight gain by inducing adipocyte apoptosis in high fat diet induced mice. Thus, it may be used to treat obese patients with hypercholesterolemia and hypertriglyceridemia.

  12. An eudesman derivative from Verbesina persicifolia D.C. as a natural mild uncoupler in liver mitochondria. A new potential anti-obesity agent?

    Science.gov (United States)

    Dalla Via, Lisa; García-Argáez, Aída N; Braga, Alessandra; Martínez-Vázquez, Mariano; Grancara, Silvia; Martinis, Pamela; Agostinelli, Enzo; Toninello, Antonio

    2014-01-01

    4β-cinnamoyloxy,1β,3α-dihydroxyeudesm-7,8-ene (CDE) extracted from Verbesina persicifolia induces bioenergetic collapse in rat liver mitochondria (RLM), monitored as a fall in the respiratory control index and ADP/O values. This fall in energy is accompanied by a protonophore effect and membrane potential (Δψ) collapse, demonstrating that CDE behaves as a typical uncoupling agent. However, when examining the effect of CDE in detail, we found that it acts as a "mild" uncoupler because it drops Δψ and increases respiratory state 4. The proposed mechanism is based on the interaction of CDE with membrane protein cytochrome C oxidase, which is implicated in proton permeability, and with the respiratory chain for the generation of reactive oxygen species which mediate and regulate the activity of the above membrane protein. Considering the energy collapse, "mild" uncoupling, and the fact that CDE is largely used in folk medicines, this extract may be viewed as a potentially effective anti-obesity drug and a natural lead compound for developing new natural uncouplers against obesity. PMID:23701541

  13. Coronary Artery Bypass

    Directory of Open Access Journals (Sweden)

    Kadri Ceberut

    2011-01-01

    Full Text Available Ancient schwannoma is a rare variant of neural tumors though rarely seen in the thorax. The combination with coronary artery diseases is also rare. Here we describe a 66 year-old male who had undergone one-stage combined surgery for thoracic ancient schwannomas removal and coronary artery disease. The masses were, respectively, 13 cm in the middle mediastinum and 5 cm in diameter originating from the intercostal nerve. The tumors were successfully removed using sternotomy, and then a coronary artery bypass grafting was performed. Here we discuss this rare tumor in relation to the relevant literature.

  14. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

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    Full Text Available ... the pouch, the connection, and we did it. Let’s go ahead and give me some more water up ... then we discontinue the antibiotics after that. Now let’s just go -- Tony, can you review everything sort an overview ...

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    Full Text Available ... complications of the surgery is something called an “internal hernia,” and that can happen later on. It’s ... of infection because of their loss of glucose control. But our infection rates in those patients that ...

  16. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

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    Full Text Available ... that have diabetes mellitus type II, and that’s diabetes associated with obesity. And there’s no question that the great thing about bariatric surgery is that the weight loss that’s associated with the ... be healed of their diabetes, which is a great thing. The other question ...

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    Full Text Available ... less amount of calories and less amount of food. 8 OR Live bah 2777 show Another question is, “Do the patients go through any psychological therapy prior to surgery to ensure that they’re capable of controlling their eating habits.” Really, we put all the patients through a ...

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    Full Text Available ... we put all the patients through a psychological evaluation, and it’s not to see if they have ... The reason we put them through a psychological evaluation is that we want our patients to have ...

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    Full Text Available ... cholecystectomy, and you can see all the scar tissue, which we have already taken down from up ... here, and we took down all this scar tissue that was stuck up here, and we did ...

  20. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

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    Full Text Available ... probably the standard of care today for prostate cancer. This is our eighth webcast. This is going ... It’s also used in thoracic surgery for lung cancer, for lung tumors, gynecologic procedures -- the hysterectomy being ...

  1. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

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    Full Text Available ... abdominal cavity, and we’re going to insufflate air. Once he insufflates the air, the pressure within the small bowel will increase, ... leak off. So there he is insufflating the air. Tony, can you show us where the pouch ...

  2. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

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    Full Text Available ... intestine on what we’ll call the antimesenteric border, and he’s going to introduce a stapler into ... see are sleep apnea. Sleep apnea is a disease that’s seen in a lot of the patients ...

  3. Changes in Hematology and Calcium Metabolism After Gastric Bypass Surgery

    DEFF Research Database (Denmark)

    Worm, Dorte; Madsbad, Sten; Kristiansen, Viggo B;

    2015-01-01

    months after surgery. Daily supplement of 800 mg calcium, 800 U vitamin D, a multivitamin, and a vitamin B12 injection (1 mg) every third month was recommended. In subjects with low ferritin and decreasing hemoglobin levels, oral, or intravenous iron was administered. RESULTS: Hemoglobin concentration...

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    Full Text Available ... account of how the operation works. During that time, I’d like to answer questions that the ... have to be standing for long periods of time. And the ergonomics, just the manipulation of the ...

  5. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

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    Full Text Available ... procedures? We know that patients who have morbid obesity or have a BMI greater than 40, that, ... a day. Other problems that patients with morbid obesity have are hypertension, increased cholesterol and triglycerides, and ...

  6. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

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    Full Text Available ... these multiple medical problems make their lifestyle, their life a lot more difficult, and more expensive for ... serious diseases, so they can live a better life and a happier life. Here’s another question that ...

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    Full Text Available ... taking multiple medications, and having to check their blood sugar several times a day. Other problems that patients with morbid obesity have are hypertension, increased cholesterol and triglycerides, and we know that ...

  8. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

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    Full Text Available ... of it. This is the stapler that we use to divide the intestine. It staples and divides ... pulmonary surgery. The other procedure that we can use it in is urologic surgery, and one of ...

  9. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

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    Full Text Available ... of the most common procedures done for morbid obesity today. One of the landmark studies that was done was the NIH Conference study in 1991 at the National Institute of Health in Washington, D.C. And what they looked ...

  10. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

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    Full Text Available ... two different principals for weight loss, one is restrictive in what we do. We actually take a ... the rest of the stomach, and that’s the restrictive part of the procedure. And it’s self-explanatory, ...

  11. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

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    Full Text Available ... going from doing it laparoscopic to doing it open is a much shorter learning curve, and the surgeons who are proficient robotic surgeons can quickly become very proficient doing the case robotically. As ... done robotically versus open. And with time, that will be able to ...

  12. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

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    Full Text Available ... 40; that if you put them on strict diet and exercise, supervised by a physician, that only one percent, that’s one percent of those patients were actually able to lose enough weight. And because of that, in 1991 the recommendation of the NIH was that those patients who ...

  13. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

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    Full Text Available ... surgical procedures? We know that patients who have morbid obesity or have a BMI greater than 40, that, ... times a day. Other problems that patients with morbid obesity have are hypertension, increased cholesterol and triglycerides, and ...

  14. Metabolic surgery: gastric bypass and type 2 diabetes

    Directory of Open Access Journals (Sweden)

    Enrique Lanzarini

    2012-08-01

    Full Text Available Currently, type 2 diabetes mellitus and obesity behave as epidemic diseases. Medical treatment has not been able to achieve adequate metabolic control in a sufficient number of patients and is not exempt of complications. Meanwhile, the group of diabetics with severe and morbid obesity that have undergone bariatric surgery have mostly evolved with remission of their diabetes in the medium and long term, so that surgery has become the first choice of treatment. This early post operative remission is not explained by weight loss only, as other mechanisms linked to anatomic and functional changes mediated by surgery are under research. There is a great interest to explore new treatment options for type 2 diabetes including surgery in patients with mild to severe obesity, which has been denominated metabolic surgery.

  15. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

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    Full Text Available ... risks of having multiple medical problems. Those are medical problems that can hamper the lifestyle of the patients and shorten their lifespan. We know patients who have morbid obesity live 8 to 13 years less than those ...

  16. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

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    Full Text Available ... Dr. Anthony Gonzalez, and welcome to South Miami Hospital. We’re here for a live webcast, a ... re in the operating room at South Miami Hospital in South Miami, Florida. We have here the ...

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    Full Text Available ... Gonzalez divides the intestine, now he’s going to measure it a certain distance, and that’s the amount ... same level as the umbilicus. And again, they measure any where from 12 millimeters to 5 millimeter ...

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    Full Text Available ... infection in the abdomen, whether it be an appendicitis or a gallbladder problem, this omentum in obese ... It will stick down to an area of appendicitis. So that’s what it is, it’s fat, and ...

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    Full Text Available ... factors are increased lipids, sleep apnea, gastroesophageal reflux disease, and depression. She has a previous open cholecystectomy, ... see are sleep apnea. Sleep apnea is a disease that’s seen in a lot of the patients ...

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    Full Text Available ... call, weighs approximately 243 pounds, has a body mass index or a BMI of 41, which qualifies ... instance, this patient here, who has a body mass index of 41, we know that those patients ...

  1. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

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    Full Text Available ... surgery to ensure that they’re capable of controlling their eating habits.” Really, we put all the ... he’s all done, we’ll go by and review everything in detail, and Dr. Gonzalez can show ...

  2. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

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    Full Text Available ... We actually take a small portion of the stomach and divide it from the rest of the stomach, and that’s the restrictive part of the procedure. ... see, it’s a very small portion of the stomach. The other portion of the operation is the ...

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    Full Text Available ... the restrictive part of the procedure. And it’s self-explanatory, because as you can see, it’s a ... we have is, “How is it going to change the patient’s eating habits?” Well as you can ...

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    Full Text Available ... problems, and these multiple medical problems make their lifestyle, their life a lot more difficult, and more ... Those are medical problems that can hamper the lifestyle of the patients and shorten their lifespan. We ...

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    Full Text Available ... ma may see in the world. Now the patient is positioned. The patient is under general anesthesia. The head is over ... the robot is brought and docked over the patient’s body and ready to be used. Once I ...

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    Full Text Available ... problems that patients with morbid obesity have are hypertension, increased cholesterol and triglycerides, and we know that those patients who have hypertension, increased triglycerides, and cholesterol and are morbidly obese ...

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    Full Text Available ... at this point, and then the digestion and absorption of the nutrients will occur after this anastomosis. ... mix with the food, and that’s where the absorption begins. So the patient is at a disadvantage. ...

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    Full Text Available ... who could not lose the weight they, they should be recommended to have bariatric surgery, and the ... the horse, back on their diet, as they should. Again, if there’s any viewer questions, please click ...

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    Full Text Available ... the camera, so you’re centralized around the action or where the surgical procedure is being done. ... catching the backend of this, this is the liver. We’re inside the patient’s abdomen, and this ...

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    Full Text Available ... of the comorbidities, the diabetes especially. But as far as weight loss and the experience that we ... simple procedure, and it’s reversible. It’s approximately, as far as a cost, it’s probably pretty close to ...

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    Full Text Available ... re having the surgery; that they understand in detail as to how the surgical procedure works. And ... we’ll go by and review everything in detail, and Dr. Gonzalez can show us the pouch, ...

  12. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

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    Full Text Available ... leaks out. Now this is one of the beauties of robotic surgery, you can see the manipulation ... ll have a great understanding, but as the months go on, they’ll start forgetting what it ...

  13. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

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    Full Text Available ... So Dr. Gonzalez now is going to be measuring out the small bowl, approximately 150 centimeters just ... is done through five small incisions, and it’s measuring anywhere from 12 millimeters to 5 millimeters, and ...

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    Full Text Available ... is important. The surgical procedure is important, the diet that the patients are advised on, exercise, so ... 40; that if you put them on strict diet and exercise, supervised by a physician, that only ...

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    Full Text Available ... which qualifies her for the surgery. Her risk factors are increased lipids, sleep apnea, gastroesophageal reflux disease, ... is important. The surgical procedure is important, the diet that the patients are advised on, exercise, so ...

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    Full Text Available ... this way. The bile and the pancreatic juices mix with the food, and then head south. And ... where the bile and the pancreatic juices will mix with the food, and that’s where the absorption ...

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    Full Text Available ... and are morbidly obese have higher incidents of heart problems. The other things that we see are sleep apnea. Sleep apnea is a disease that’s seen in a lot of the patients ...

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    Full Text Available ... to my staff, the people that help make this is a Center of Excellence in bariatric surgery. ... screen in that direction. The feet are in this direction. And the robot is brought and docked ...

  19. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

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    Full Text Available ... patient today. Basically, the patient is a 43-year-old white female who is five-feet-five- ... the big incision that we used to do years ago and would hamper recovery, long hospital stays, ...

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    Full Text Available ... limb.” That is the bile and the pancreatic juices come in this way, and then this is ... coming this way. The bile and the pancreatic juices mix with the food, and then head south. ...

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    Full Text Available ... feet-five-inches call, weighs approximately 243 pounds, has a body mass index or a BMI of ... sleep apnea, gastroesophageal reflux disease, and depression. She has a previous open cholecystectomy, not laparoscopic, and that ...

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    Full Text Available ... he’s all done, we’ll go by and review everything in detail, and Dr. Gonzalez can show ... in. We send them back to nutritionist. They review everything with them and they get back on ...

  3. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

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    Full Text Available ... patients lose the weight through bariatric surgery, those issues that have decreased their lifespan and made their ... of the time, it’s going to be behavioral issues. One of the things that we put the ...

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    Full Text Available ... will go away. If you go see your doctor today and you’re a diabetic, he’s got ... always get asked by patients and even other physicians that are not familiar with robotic surgery. You’ ...

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    Full Text Available ... four other ones, are laterally along the same level as the umbilicus. And again, they measure any where from 12 millimeters to 5 millimeter in size. So basically this is the ...

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    Full Text Available ... that it’s required that the patients be on vitamins for the rest of their lives. And it’s ... that it’s good for them to be on vitamins. It’s crucial that they be on vitamins because ...

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    Full Text Available ... for the surgery. Her risk factors are increased lipids, sleep apnea, gastroesophageal reflux disease, and depression. She ... Walgreens. So it’s a glue. It’s made from human. It’s Evicel, and it’s a fibrin glue. And ...

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    Full Text Available ... question is, “Do the patients go through any psychological therapy prior to surgery to ensure that they’re capable of controlling their eating habits.” Really, we put all the patients through a psychological evaluation, and it’s not to see if they ...

  9. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

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    Full Text Available ... procedures. It’s also used in thoracic surgery for lung cancer, for lung tumors, gynecologic procedures -- the hysterectomy being one of the most common ones -- urologic procedures, and robotic prostectomy for prostate cancer is a procedure that has been proven time ...

  10. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

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    Full Text Available ... It’s also used in thoracic surgery for lung cancer, for lung tumors, gynecologic procedures -- the hysterectomy being one of the most common ones -- urologic procedures, and robotic prostectomy for prostate cancer is a procedure that has been proven time ...

  11. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

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    Full Text Available ... showing up in the webcast, this is a three-dimension high-definition picture that we have as ... it’s a disease that can be a problem. 3 OR Live bah 2777 show Dr. Gonzalez is ...

  12. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

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    Full Text Available ... doing well. She will have a detailed diet book that she’s going to be guided by as ... support group here at South Miami Hospital that helps the patients. It’s one of the bigger support ...

  13. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

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    Full Text Available ... The answer to this is, “No.” There’s no advantage to doing this. The fat will be lost ... ll avoid it, and that’s one of the advantages of it. Another question, “You just said that ...

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    Full Text Available ... with. So the way -- usually when you eat something, usually you eat and it’s solid, it’s liquid and fluid, and when you’re eating something, the stomach will start to dilate. As the ...

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    Full Text Available ... that we have, just because of all the education that they’re going through. Now, again, Dr. Gonzalez is finishing up a couple staples there. He’s going to put another suture line to finish up there. And the operation is ...

  16. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

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    Full Text Available ... doing well. She will have a detailed diet book that she’s going to be guided by as ... The answer to this is, “No.” There’s no advantage to doing this. The fat will be lost ...

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    Full Text Available ... introduce you to my staff, the people that help make this is a Center of Excellence in ... is where the nutrients and those elements that help in the digestive process are going to meet. ...

  18. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

    Science.gov (United States)

    ... we put them on full liquids, then a soft diet, and puréed diet later on. So the important things here for this patient, this morbidly obese patients with all the medical problems she has is, one, the surgery; two, ...

  19. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

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    Full Text Available ... we put them on full liquids, then a soft diet, and puréed diet later on. So the important things here for this patient, this morbidly obese patients with all the medical problems she has is, one, the surgery; two, ...

  20. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

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    Full Text Available ... her liquid diet, has no pain and no fever, the patient will go home. Subsequently, we’ll ... of our listeners is asking “What is the yellow material?” Can you just tell them what that ...

  1. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

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    Full Text Available ... 5 millimeters, and then we have the camera port also, and that’s one of the other advantages ... questions that we have is “Where are the ports?” The ports are evenly spaced around the abdominal ...

  2. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

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    Full Text Available ... for one thing. An example of that are diabetics. People who are morbidly obese have high incidents of diabetes II. As you know, diabetics are patients who have no blood control of -- ...

  3. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

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    Full Text Available ... the restrictive part of the procedure. And it’s self-explanatory, because as you can see, it’s a ... two is the malabsorptive portion of the operation. Now what I would like to have you -- Dr. ...

  4. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

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    Full Text Available ... sutures. So he’s going to suture shut that hole there. And you can see how well the ... Dr. Gonzalez has down now, he’s creating a hole in the small bowel. He already created the ...

  5. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

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    Full Text Available ... we do is we take part of the intestine, exclude it from the digestive process, and later, ... showing you is the beginning of the small intestine, and he’s going to run the bowel down -- ...

  6. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

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    Full Text Available ... we have an added dimension, and the depth perception is incredible and just aids the surgery a ... have to be standing for long periods of time. And the ergonomics, just the manipulation of the ...

  7. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

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    Full Text Available ... important in the digestive process are going to meet right at this point, and then the digestion ... help in the digestive process are going to meet. And now what he’s going to do, he’s ...

  8. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

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    Full Text Available ... is a Bariatric Center of Excellence is the education of the patients. The surgical procedure that Dr. ... can be used for the weight loss. The education is extremely important, and most of the patients ...

  9. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

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    Full Text Available ... from the stomach and separating it from the food, and then allowing that reaction that digestive process ... as that mini stomach gets dilated with the food and everything else that’s going into it, it ...

  10. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

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    Full Text Available ... degrees with seven ranges of motion, whereas a standard laparoscopic procedure, we just cannot do that, and ... is the robotic prostatectomy, which is probably the standard of care today for prostate cancer. This is ...

  11. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

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    Full Text Available ... degrees with seven ranges of motion, whereas a standard laparoscopic procedure, we just cannot do that, and ... the webcast, this is a three-dimension high-definition picture that we have as surgeons. Laparoscopic surgery, ...

  12. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

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    Full Text Available ... is, “Do the patients go through any psychological therapy prior to surgery to ensure that they’re ... the hole was, you put the tire under water, you’d squeeze it, and then where it ...

  13. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

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    Full Text Available ... 41, which qualifies her for the surgery. Her risk factors are increased lipids, sleep apnea, gastroesophageal reflux ... surgical procedures to the patients. We explain the risk and complications of the surgery, the different options ...

  14. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

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    Full Text Available ... is probably the standard of care today for prostate cancer. This is our eighth webcast. This is ... common ones -- urologic procedures, and robotic prostectomy for prostate cancer is a procedure that has been proven ...

  15. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

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    Full Text Available ... we call the “dumping syndrome.” And the dumping syndrome is something in that we know patients who undergo the surgery will not feel well if they eat things high in carbohydrates, high in sugar, and they’ll get sweaty. Their heart will race. They’ll get what we call “ ...

  16. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

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    Full Text Available ... 90 percent of the stomach out and you leave a small sleeve of stomach, and that, again, ... are important in the digestive process, so we leave that part of the stomach there, as opposed ...

  17. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

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    Full Text Available ... just to make sure, as another layer of confidence that everything is going well with the surgery. ... four other ones, are laterally along the same level as the umbilicus. And again, they measure any ...

  18. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

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    Full Text Available ... motion in seven directions, very similar to the human wrist, which is what the surgeon would be ... Walgreens. So it’s a glue. It’s made from human. It’s Evicel, and it’s a fibrin glue. And ...

  19. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

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    Full Text Available ... low carbohydrate diet. And an important thing is nutrition, so we have nutritionists here at South Miami ... Miami Hospital in our Center of Excellence Bariatric Program, and I’m signing out. Thank you, guys. ...

  20. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

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    Full Text Available ... we have an added dimension, and the depth perception is incredible and just aids the surgery a ... important is support. This is a life-changing event for these patients, and they need support from ...

  1. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

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    Full Text Available ... we have an added dimension, and the depth perception is incredible and just aids the surgery a ... we have is, “How is it going to change the patient’s eating habits?” Well as you can ...

  2. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

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    Full Text Available ... the surgery. Her risk factors are increased lipids, sleep apnea, gastroesophageal reflux disease, and depression. She has ... problems. The other things that we see are sleep apnea. Sleep apnea is a disease that’s seen ...

  3. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

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    Full Text Available ... could be that the patients are eating more food. You know, one of the things that we ... liquids can go down quickly, whereas more solid foods may not. So you have to be careful ...

  4. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

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    Full Text Available ... from this is what we call the “dumping syndrome.” And the dumping syndrome is something in that we know patients who ... carbohydrate diet, so if they get the dumping syndrome, they’ll avoid it, and that’s one of ...

  5. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

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    Full Text Available ... the restrictive part of the procedure. And it’s self-explanatory, because as you can see, it’s a ... is where the nutrients and those elements that help in the digestive process are going to meet. ...

  6. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

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    Full Text Available ... up here, and we did that for the benefit of time. So then we’re creating this ... if you put them on strict diet and exercise, supervised by a physician, that only one percent, ...

  7. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

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    Full Text Available ... going to introduce a stapler into each of these two pieces of bowel and staple them together ... unique and allows us to do some of these procedures in other operative procedures. Robotic surgery can ...

  8. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

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    Full Text Available ... the patients will stop losing weight at about 18 months, about a year-and-a-half after ... loss. So most patients, by the time it’s 18 months, they have lost most of the weight ...

  9. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

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    Full Text Available ... no blood control of -- no control of their blood sugar, and because of this, they may have to ... taking multiple medications, and having to check their blood sugar several times a day. Other problems that patients ...

  10. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

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    Full Text Available ... robotic prostatectomy, which is probably the standard of care today for prostate cancer. This is our eighth ... years ago, and we sometimes have to take care of it surgically. Again, for those viewers that ...

  11. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

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    Full Text Available ... other people around them. We have a support group here at South Miami Hospital that helps the patients. It’s one of the bigger support groups here in South Florida, and it’s extremely important. ...

  12. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

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    Full Text Available ... absorbed. So actually we’re taking the reactive products, the bile, the amylase, and the acid coming ... and it’s extremely important. These patients have to relate to other patients who are going through the ...

  13. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

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    Full Text Available ... and this is where the nutrients, what the person eats, and the elements that are important in the digestive process are going to meet right at this point, and then the digestion and absorption ...

  14. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

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    Full Text Available ... we put the patients on is a high protein, low carbohydrate diet. And an important thing is ... does it mean to be on a high protein, low carbohydrate diet? And a lot of the ...

  15. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

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    Full Text Available ... of the intestine, exclude it from the digestive process, and later, allow the nutrients that the patient ... food, and then allowing that reaction that digestive process to occur later and get absorbed less than ...

  16. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

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    Full Text Available ... medication. He’s not going to be able to cure you of that diabetes. You cannot get cured ... surgery, with the weight loss we can actually cure it so you’re not on any medications ...

  17. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

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    Full Text Available ... enclosed it, and you cannot leave an enclosed structure like that within the abdominal cavity. Getting back ... and that can happen later on. It’s rare, but it can help. It’s something that we recognize ...

  18. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

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    Full Text Available ... week to make sure the patient is doing well. She will have a detailed diet book that she’s going to be guided by as to how she proceeds with ... patients who undergo the surgery will not feel well if they eat things high ... don’t want the patients to be on a high carbohydrate diet, so if they ...

  19. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

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    Full Text Available ... patients with morbid obesity have are hypertension, increased cholesterol and triglycerides, and we know that those patients who have hypertension, increased triglycerides, and cholesterol and are morbidly obese have higher incidents of ...

  20. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

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    Full Text Available ... the hole was, you put the tire under water, you’d squeeze it, and then where it ... the small bowel, and then we’re putting water inside the abdominal cavity, and we’re going ...

  1. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

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    Full Text Available ... has finished the anastomosis and they have the NG tube within the anastomosis. You can sort of ... Give me -- release it. You can see the NG tube right here Jorge. The NG tube is ...

  2. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

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    Full Text Available ... is probably the standard of care today for prostate cancer. This is our eighth webcast. This is going ... common ones -- urologic procedures, and robotic prostectomy for prostate cancer is a procedure that has been proven time ...

  3. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

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    Full Text Available ... we have an added dimension, and the depth perception is incredible and just aids the surgery a ... problems. The other things that we see are sleep apnea. Sleep apnea is a disease that’s seen ...

  4. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

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    Full Text Available ... standing for long periods of time. And the ergonomics, just the manipulation of the hands in front ... we have, the visualization, the precision, and the ergonomics, how easy it is. You’re sitting at ...

  5. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

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    Full Text Available ... the diet that the patients are advised on, exercise, so on and so forth. We have seminars ... if you put them on strict diet and exercise, supervised by a physician, that only one percent, ...

  6. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

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    Full Text Available ... d like to do is give you an animation of what the surgical procedure involves, and during that animation I’ll explain to you what’s going on ... to come up, that you saw on the animation, that’s going to come up to the pouch, ...

  7. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

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    Full Text Available ... the sites of where the ports are inserted. Antibiotics are given just prior to the surgical procedure, ... after the surgery, and then we discontinue the antibiotics after that. Now let’s just go -- Tony, can ...

  8. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

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    Full Text Available ... it, it will send the same signal to the brain that you’re full, and you’ll stop ... It’s also used in thoracic surgery for lung cancer, for lung tumors, gynecologic procedures -- the hysterectomy being ...

  9. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

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    Full Text Available ... can be used in other operative specialties including cardiac surgery, thoracic surgery, which is pulmonary surgery. The ... and are morbidly obese have higher incidents of heart problems. The other things that we see are ...

  10. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

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    Full Text Available ... without further adieu, let me send you out, right outside our doors to my partner, Dr. Jorge ... small intestine -- down to approximately 40 centimeter, and right there it’s marked with a suture. So this ...

  11. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

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    Full Text Available ... how the operation works. During that time, I’d like to answer questions that the viewers will ... we possibly have. By way of introduction, I’d like to tell you about our patient today. ...

  12. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

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    Full Text Available ... blood control of -- no control of their blood sugar, and because of this, they may have to ... multiple medications, and having to check their blood sugar several times a day. Other problems that patients ...

  13. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

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    Full Text Available ... summarize, this is a fibrin glue. This is biologic glue. This is not the glue you get ... of 12 OR Live bah 2777 show glue -- biologic glue to it just in the case there’s ...

  14. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

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    Full Text Available ... who are morbidly obese have high incidents of diabetes II. As you know, diabetics are patients who ... do lose a lot of the comorbidities, the diabetes especially. But as far as weight loss and ...

  15. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

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    Full Text Available ... multiple medications, and having to check their blood sugar several times a day. Other problems that patients with morbid obesity have are hypertension, increased cholesterol and triglycerides, and ...

  16. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

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    Full Text Available ... ve actually completely enclosed it, and you cannot leave an enclosed structure like that within the abdominal cavity. Getting back to the operation, you can see Dr. Gonzalez working on the console now. And he’s going to ...

  17. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

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    Full Text Available ... morbid obesity have are hypertension, increased cholesterol and triglycerides, and we know that those patients who have hypertension, increased triglycerides, and cholesterol and are morbidly obese have higher ...

  18. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

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    Full Text Available ... digestive process; for example, the bile, the pancreatic enzymes and the acid that’s coming from the stomach, ... things are important in the digestive preprocess, the enzyme. 5 OR Live bah 2777 show Now can ...

  19. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

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    Full Text Available ... that hole there. And you can see how well the bowel -- how well the sutures in and the needle is manipulating ... bah 2777 show But in your experience, as well, Dr. Rabaza, you can say that we’re ...

  20. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

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    Full Text Available ... know, diabetics are patients who have no blood control of -- no control of their blood sugar, and because of this, ... of infection because of their loss of glucose control. But our infection rates in those patients that ...

  1. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

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    Full Text Available ... which qualifies her for the surgery. Her risk factors are increased lipids, sleep apnea, gastroesophageal reflux disease, ... and this is where the nutrients, what the person eats, and the elements that are important in ...

  2. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

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    Full Text Available ... this is the small intestine -- down to approximately 40 centimeter, and right there it’s marked with a ... morbid obesity or have a BMI greater than 40, that, by definition, are morbidly obese, have increased ...

  3. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

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    Full Text Available ... And as you can see, some of the advantages of robotic surgery is the manipulation, as you ... me just point out some of the other advantages of robotic surgery, and one is visualization. Although ...

  4. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

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    Full Text Available ... to doing it open is a much shorter learning curve, and the surgeons who are proficient robotic surgeons can ... back to nutritionist. They review everything with them and they get back on the horse, back on their diet, as they should. Again, ...

  5. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

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    Full Text Available ... specialties including cardiac surgery, thoracic surgery, which is pulmonary surgery. The other procedure that we can use ... procedures. It’s also used in thoracic surgery for lung cancer, for lung tumors, gynecologic procedures -- the hysterectomy ...

  6. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

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    Full Text Available ... a liquid diet. And if she’s doing well, meaning that she’s drinking her liquid diet, has no ... the horse, back on their diet, as they should. Again, if there’s any viewer questions, please click ...

  7. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

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    Full Text Available ... the patient is a 43-year-old white female who is five-feet-five-inches call, weighs approximately 243 pounds, has a body mass index or a BMI of 41, which qualifies her for the surgery. Her risk factors are increased lipids, sleep apnea, gastroesophageal reflux disease, ...

  8. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

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    Full Text Available ... increased lipids, sleep apnea, gastroesophageal reflux disease, and depression. She has a previous open cholecystectomy, not laparoscopic, ... these multiple medical problems make their lifestyle, their life a lot more difficult, and more expensive for ...

  9. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

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    Full Text Available ... triglycerides, and cholesterol and are morbidly obese have higher incidents of heart problems. The other things that ... of the viewers is “Is the infection rate higher or lower with the robot- assisted?” We don’ ...

  10. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

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    Full Text Available ... exercise, so on and so forth. We have seminars on a weekly basis in which we explain ... are extremely educated before they come to the seminars and even more so afterwards. So education, the ...

  11. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

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    Full Text Available ... you’re sort of fooling the stomach into thinking that you’re eating a lot of food, ... procedure. And again, this is part of the education of the patient. And us here as a ...

  12. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

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    Full Text Available ... meet right at this point, and then the digestion and absorption of the nutrients will occur after ... add it is an important part of the digestion of food. Now that stomach is out of ...

  13. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

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    Full Text Available ... patients is that they cannot do any heavy lifting for a month. And the reason being is ... that patients after surgery should not do heavy lifting in order to not create a hernia in ...

  14. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

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    Full Text Available ... white female who is five-feet-five-inches call, weighs approximately 243 pounds, has a body mass ... that bleeding will be stopped by what we call the “Harmonic scalpel.” So once Dr. Gonzalez divides ...

  15. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

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    Full Text Available ... Jorge Rabaza, and I will be moderating the operative procedure today. And basically what I’m going ... what’s going on so that you, during the operative procedure, the live procedure, you’ll understand it. ...

  16. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

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    Full Text Available ... the seminars and even more so afterwards. So education, the patient’s understanding, basic understanding of why they’re have ... procedure. And again, this is part of the education of the patient. And us here as a Center of Excellence, ...

  17. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

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    Full Text Available ... that, and we’re more hampered by our motion than the regular laparoscopic procedures. We have a little bit of bleeding there, and that bleeding will be stopped by what we call the “Harmonic scalpel.” So once Dr. Gonzalez divides the intestine, ...

  18. Spiritual Bypass: A Preliminary Investigation

    Science.gov (United States)

    Cashwell, Craig S.; Glosoff, Harriet L.; Hammond, Cheree

    2010-01-01

    The phenomenon of spiritual bypass has received limited attention in the transpersonal psychology and counseling literature and has not been subjected to empirical inquiry. This study examines the phenomenon of spiritual bypass by considering how spirituality, mindfulness, alexithymia (emotional restrictiveness), and narcissism work together to…

  19. Expression of hepatic insulin receptor-β and glucose transporter-2 after gastric bypass in rats with type 2 diabetes mellitus%胃转流术对2型糖尿病大鼠肝细胞胰岛素受体-β及葡萄糖转运蛋白-2表达的影响

    Institute of Scientific and Technical Information of China (English)

    吴惧; 徐键; 尹敏; 尹家俊; 程楠

    2016-01-01

    目的 观察胃转流术(GBP)对自发性2型糖尿病大鼠(GK大鼠)肝细胞胰岛素受体-β(IR-β)及葡萄糖转运蛋白-2(GLUT-2)表达的影响,探讨其改善胰岛素抵抗的机制.方法 30只8周龄雄性GK大鼠随机分为手术组(10只)、假手术组(10只)、饮食配对组(10只),另8周龄雄性SD作为空白对照组(10只).检测和比较术前及术后4周各组大鼠空腹血糖(FPG)、空腹胰岛素(FINS)水平,计算术前及术后4周胰岛素抵抗指数(HOMA-IR),应用Western blot技术检测各组术后4周肝细胞IR-β、GLUT-2的表达.结果 GK手术组术后4周FPG水平[(5.13 ±0.22) mmol/L]明显低于术前(P<0.05);术后4周HOMA-IR[(2.16 ±0.18) mmol/L]明显降低(P<0.01);术后4周IR-β、GLUT-2表达明显增加(P<0.01).结论 GBP能上调2型糖尿病大鼠肝细胞胰岛素信号转导通路中IR-β及GLUT-2的表达,改善肝细胞胰岛素抵抗,提高胰岛素的敏感性.%Objective To investigate the expression of hepatic insulin receptor-β (IR-β) and glucose transporter-2 (GLUT-2) after gastric bypass (GBP) in rats with spontaneous type 2 diabetes mellitus (GK rats) and to discuss the mechanisms of GBP improving insulin resistance.Methods Thirty 8-week-old male GK rats were randomly divided into 3 groups:the operation group (n =10),the sham operation group (n =10) and the diet pairing group (n =10).Ten 8-week-old male SD rats served as blank control group.The levels of fasting blood glucose (FPG) and fasting insulin (FINS) were measured and compared among the 4 groups before and at 4th weeks after the operation,and the HOMA-IR was calculated respectively,and then the rats were decapitated to retrieve the liver.The expression of hepatic IR-β and GLUT-2 was detected by Western blotting.Results In GK operation group,the FPG level [(5.13 ±0.22) mmol/L] decreased significantly after the operation (P < 0.05),and the HOMA-IR level [(2.16 ±0.18) mmol/L] decreased significantly too (P <0.01).The expression

  20. 腹腔镜 Roux-en-Y 胃旁路术治疗肥胖合并2型糖尿病的疗效%Efficacy of Laparoscopic Roux-en-Y Gastric Bypass Surgery in the Treatment of Obesity Accompanied by Type 2 Diabetes

    Institute of Scientific and Technical Information of China (English)

    黄文海

    2015-01-01

    目的:探讨腹腔镜 Roux-en-Y 胃旁路术(LRYGB)治疗肥胖合并2型糖尿病的疗效。方法:选择54例行 LRYGB 治疗的2型糖尿病患者,分为研究组[体质量指数(BMI)≥28 kg/m 2]40例和对照组14例(BMI <28 kg/m 2),比较治疗效果。结果:研究组手术总时间长于对照组,两组手术总出血量、术后初次下床活动时间、术后并发症发生率差异均无统计学意义。术后6个月研究组和对照组空腹血糖(FBG)、空腹胰岛素(FINS)、稳态模型评估胰岛素抵抗指数(HOMA-IR)、餐后2 h 血糖(2 h FBG)和糖化血红蛋白(HbA1c)均较术前明显降低,空腹 C 肽显著增高。术后6个月研究组 HbA1c 水平显著低于对照组(P<0.05)。研究组临床有效率显著高于对照组(P=0.024)。结论: LRYGB 治疗肥胖合并2型糖尿病患者较非肥胖患者疗效更好。%Objective : To investigate the efficacy of laparoscopic Roux-en-Y gastric bypass surgery (LRYGB ) for the treatment of obesity accompanied by type 2 diabetes .Methods : Fifty-four patients with type 2 diabetes undertaking LRYGB treatment were collected and divided into study group (body mass index ,BMI ≥ 28 kg/m 2 ) with 40 cases and control group (BMI < 28 kg/m 2 ) with 14 cases .And therapeutic effect was compared between the two groups .Results : The total operative time in study group was longer than that in control group .There was no statistically significant difference regarding total amount of intraoperative bleeding , postoperative ambulation first time , postoperative complication rate between the two groups .Six months after surgery ,FBG ,FINS ,HOMA-IR ,2 h FBG and HbA1c in both study group and control group were significantly lower than before surgery ,while fasting C-peptide was significantly higher .And six months after surgery ,HbA1c level in study group was significantly lower than that in control group (P< 0 .05) .The overall

  1. A Hamster Model of Diet-Induced Obesity for Preclinical Evaluation of Anti-Obesity, Anti-Diabetic and Lipid Modulating Agents.

    Directory of Open Access Journals (Sweden)

    Louise S Dalbøge

    Full Text Available Unlike rats and mice, hamsters develop hypercholesterolemia, and hypertriglyceridemia when fed a cholesterol-rich diet. Because hyperlipidemia is a hallmark of human obesity, we aimed to develop and characterize a novel diet-induced obesity (DIO and hypercholesterolemia Golden Syrian hamster model.Hamsters fed a highly palatable fat- and sugar-rich diet (HPFS for 12 weeks showed significant body weight gain, body fat accumulation and impaired glucose tolerance. Cholesterol supplementation to the diet evoked additional hypercholesterolemia. Chronic treatment with the GLP-1 analogue, liraglutide (0.2 mg/kg, SC, BID, 27 days, normalized body weight and glucose tolerance, and lowered blood lipids in the DIO-hamster. The dipeptidyl peptidase-4 (DPP-4 inhibitor, linagliptin (3.0 mg/kg, PO, QD also improved glucose tolerance. Treatment with peptide YY3-36 (PYY3-36, 1.0 mg/kg/day or neuromedin U (NMU, 1.5 mg/kg/day, continuously infused via a subcutaneous osmotic minipump for 14 days, reduced body weight and energy intake and changed food preference from HPFS diet towards chow. Co-treatment with liraglutide and PYY3-36 evoked a pronounced synergistic decrease in body weight and food intake with no lower plateau established. Treatment with the cholesterol uptake inhibitor ezetimibe (10 mg/kg, PO, QD for 14 days lowered plasma total cholesterol with a more marked reduction of LDL levels, as compared to HDL, indicating additional sensitivity to cholesterol modulating drugs in the hyperlipidemic DIO-hamster. In conclusion, the features of combined obesity, impaired glucose tolerance and hypercholesterolemia in the DIO-hamster make this animal model useful for preclinical evaluation of novel anti-obesity, anti-diabetic and lipid modulating agents.

  2. Cardiopulmonary bypass in pregnancy

    Directory of Open Access Journals (Sweden)

    Mukul Chandra Kapoor

    2014-01-01

    Full Text Available Cardiac surgery carried out on cardiopulmonary bypass (CPB in a pregnant woman is associated with poor neonatal outcomes although maternal outcomes are similar to cardiac surgery in non-pregnant women. Most adverse maternal and fetal outcomes from cardiac surgery during pregnancy are attributed to effects of CPB. The CPB is associated with utero-placental hypoperfusion due to a number of factors, which may translate into low fetal cardiac output, hypoxia and even death. Better maternal and fetal outcomes may be achieved by early pre-operative optimization of maternal cardiovascular status, use of perioperative fetal monitoring, optimization of CPB, delivery of a viable fetus before the operation and scheduling cardiac surgery on an elective basis during the second trimester.

  3. Gastric cancer

    International Nuclear Information System (INIS)

    Although gastric cancers are localized and surgically resectable in approximately 50% of patients at the time of diagnosis, regional metastases and direct invasion of surrounding structures frequently preclude cure by surgery alone. With recurrent or metastatic disease, some palliation can be obtained by chemotherapy, surgery, or irradiation, but few patients can actually be cured. This chapter addresses the rationale for adjuvant treatment in resectable disease and discusses results with single or combined modalities in locally advanced disease. The chapter also discusses future possibilities for aggressive combined modality approaches in patients who have undergone resection but are at high risk, who have undergone resection but have residual disease, or who have locally unresectable or recurrent disease

  4. Heart bypass surgery - minimally invasive

    Science.gov (United States)

    ... MIDCAB; Robot assisted coronary artery bypass; RACAB; Keyhole heart surgery ... To perform this surgery: The heart surgeon will make a 3- to 5-inch-long surgical cut in the left part of your chest between your ribs ...

  5. Stomach (Gastric) Cancer Prevention

    Science.gov (United States)

    ... Treatment Stomach Cancer Prevention Stomach Cancer Screening Research Stomach (Gastric) Cancer Prevention (PDQ®)–Patient Version What is ... to keep cancer from starting. General Information About Stomach Cancer Key Points Stomach (gastric) cancer is a ...

  6. Hereditary Diffuse Gastric Cancer

    Science.gov (United States)

    ... procedure done in conjunction with in-vitro fertilization (IVF). It allows people who carry a specific known ... gastric cancer before age 40 Personal or family history of both diffuse gastric cancer and lobular breast ...

  7. Ileal loop interposition:an alternative biliar y bypass technique

    Institute of Scientific and Technical Information of China (English)

    Felipe JF Coimbra; Alessandro L Diniz; Heber SC Ribeiro; Wilson L Costa Jr.; Eduardo NP Lima; André L Montagnini

    2010-01-01

    BACKGROUND: Obstructive jaundice is a common condition in advanced digestive cancer. Palliative procedures can improve quality of life and allow patients to attempt a systemic treatment. Bilioenteric anastomosis is still the procedure of choice for patients in many centers. When a surgical bypass is not possible, biliary drainage can be done by placing endoscopic or transparietal stents, which are less durable methods even when an expandable stent is employed. METHODS: A 47-year-old male with an excellent clinical status and a previous cholecystectomy and an exploratory laparotomy for advanced gastric cancer was referred with obstructive jaundice. A preoperative CT scan showed a dilated bile duct and a small mass at the distal hepatic hilum. No other signs of metastasis were found. A surgical bilioenteric anastomosis was indicated. At surgery, a distal choledochal obstruction and a mesenteric retraction by a lymph node mass prevented the jejunum to ascend for a bilioenteric anastomosis. Surgically, an alternative bilioenteric bypass was performed by means of an ileal loop interposition between the bile duct and the jejunum. RESULT: The recovery of the patient was uneventful and his bilirubin levels normalized after one week. The patient was then referred for systemic chemotherapy. CONCLUSIONS: This alternative biliary bypass can be safely and easily performed, and may be a good alternative for patients already referred for surgery because of a better life expectancy and when the jejunum is not an alternative.

  8. Bypass Rewiring and Robustness of Complex Networks

    CERN Document Server

    Park, Junsang

    2016-01-01

    A concept of bypass rewiring is introduced and random bypass rewiring is analytically and numerically investigated with simulations. Our results show that bypass rewiring makes networks robust against removal of nodes including random failures and attacks. Especially, random bypass rewiring connects all nodes except the removed nodes on an even degree infinite network and makes the percolation threshold $0$ for arbitrary occupation probabilities. In our example, the even degree network is more robust than the original network with random bypass rewiring while the original network is more robust than the even degree networks without random bypass. We propose a greedy bypass rewiring algorithm which guarantees the maximum size of the largest component at each step, assuming which node will be removed next is unknown. The simulation result shows that the greedy bypass rewiring algorithm improves the robustness of the autonomous system of the Internet under attacks more than random bypass rewiring.

  9. Expression of hepatic glucose transporter-2 and glucokinase after gastric bypass in rats with spontaneous type 2 diabetes mellitus%胃旁路术对2型糖尿病大鼠肝脏葡萄糖转运体-2及葡萄糖激酶表达的影响

    Institute of Scientific and Technical Information of China (English)

    徐键; 林杉; 尹家俊; 尹敏; 王伟; 聂哲群; 王亚东; 韩玉龙; 赵会庚

    2014-01-01

    Objective To investigate the expression of hepatic glucose transporter-2 ( GLUT-2 ) and glu-cokinase(GCK)after gastric bypass(GBP)in type 2 diabetes mellitus(T2DM)GK rats and to discuss the mecha-nism of GBP improving insulin resistance .Methods 30 male GK rats aged 8 weeks were randomly divided into 3 groups:the operation group(10 rats), the sham operation group(10 rats)and the diet control group(10 rats), and 10 male SD rats aged 8 weeks were made as blank control group .The levels of fasting plasma glucose ( FPG) and fasting insulin(FINS)were measured and compared among the 4 groups before and 1,2 and 4 weeks after the operation and then the rats were sacrificed to retrieve the liver .The expressions of GLUT-2 and GCK mRNA and protein were detected by PT-PCR and Western blot respectively .Results As for GK operation group ,FPG levels at the 1st, 2nd,and 4th week after surgery ((11.06 ±0.52) mmol/L,(7.49 ±0.34) mmol/L,(5.20 ±0.08) mmol/L)respectively)were all lower than that before surgery (all P<0.05),and FINS level at the 4th week after surgery increased from(11.90 ±0.75)mmol/L to(14.20 ±1.23)mmol/L(P<0.05).The expressions of GLUT-2 and GCK mRNA and protein significantly increased in GK operation group 4 weeks after surgery ( P<0.01 ) . Conclusion The expressions of hepatic GLUT-2 and GCK in insulin signal transmission in T2DM rats are up-regu-lated after GBP , which enhance the signal transmission of insulin receptor , and improves the insulin sensibility .%目的:观察胃旁路术(GBP)对自发性2型糖尿病(T2DM)大鼠(GK大鼠)肝细胞葡萄糖转运体-2(GLUT-2)及葡萄糖激酶(GCK)表达的影响,探讨其改善胰岛素抵抗的机制。方法30只8周龄雄性GK大鼠按照随机数字法分为手术组(10只)、假手术组(10只)、饮食配对组(10只),另8周龄雄性SD作为空白对照组(10只)。检测和比较术前及术后1、2、4周各组大鼠空腹血糖

  10. Expression of hepatic insulin receptor substrate-2 and glucose transporter-2 in rats with type 2 diabetes after gastric bypass operation%胃转流术对2型糖尿病大鼠肝组织胰岛素受体底物-2、葡萄糖转运体-2表达的影响

    Institute of Scientific and Technical Information of China (English)

    张蓬波; 陈守坤; 张秀忠; 章红; 吕墩涛; 庄步强; 温雨晴; 丁伟超; 任泽强

    2013-01-01

    Objective To observe the expression of insulin receptor substrate-2 (IRS-2) and glucose transporter-2 (GLUT-2) in rats with type 2 diabetes after gastric bypass operation (GBP),and explore the possible mechanism of GBP improving insulin resistance.Methods Healthy male SD rats were randomly divided into type 2 diabetes-operation group (DO group) and type 2 diabetes-control group (DC group) ; normal-operation group (NO group) and normal-control group (NC group).Plasma fasting glucose and insulin levels were measured respectively before and at 1st,2nd,4th and 8th week after operation.Quantitative insulin sensitivity check index (QUICKI) was measured respectively before and at 8th week after operation.The expression of hepatic IRS-2 and GLUT-2 protein and mRNa was detected by using Western blotting and reverse transcriptase-polymerase chain reaction (RT-PCR) respectively at 8th week postoperation.Results The fasting blood glucose levels in DO group were decreased from the preoperative (20.21 ±2.14) mmol/L to (8.50 ±2.19) mmol/L (P <0.05) at 8th week after GBP.The QUICKI in DO group was increased dramaticly from preoperative 0.43 ± 0.02 to 0.55 ± 0.05 at 8th week postoperation (P < 0.05).As compared with DC group,the expression of IRS-2 and GLUT-2 protein and that of IRS-2 and GLUT-2 mRNA at 8th week after operation in DO group were increased by 43% and 40% (P <0.05),and 28% and 25% (P < 0.05) respectively.Conclusion The expression of hepatic IRS-2 and GLUT-2 in rats with type 2 diabetes after GBP was up-regulated,and meanwhile the insulin sensibility was improved.%目的 观察胃转流术(GBP)对2型糖尿病(T2DM)大鼠肝组织胰岛素受体底物-2(IRS-2)、葡萄糖转运体-2(GLUT-2)表达的影响,探讨GBP改善胰岛素抵抗的机制.方法 健康雄性SD大鼠随机分为糖尿病手术组(DO组)、糖尿病对照组(DC组)、正常手术组(NO组)、正常对照组(NC组).术前及术后第1、2、4、8周分别测各组空腹血糖(FPG

  11. Nutritional and Protein Deficiencies in the Short Term following Both Gastric Bypass and Gastric Banding

    OpenAIRE

    Judith Aron-Wisnewsky; Verger, Eric O.; Carine Bounaix; Maria Carlota Dao; Jean-Michel Oppert; Jean-Luc Bouillot; Jean-Marc Chevallier; Karine Clément

    2016-01-01

    International audience BackgroundThe number of morbidly obese patients undergoing bariatric surgery (BS) has increased dramatically in recent years. Therefore, monitoring food intake and its consequences in terms of nutritional status is necessary to prevent nutritional deficiencies. The aim of this study was to analyze the effect of food restriction on nutritional parameters in the short-term (≤3 months) period after BS in morbid obesity.MethodIn a prospective study, we followed 22 obese ...

  12. Gastric emptying in patients with fundal gastritis and gastric cancer.

    OpenAIRE

    Tatsuta, M.; Iishi, H.; Okuda, S

    1990-01-01

    Gastric emptying was compared in patients with gastric cancers and fundal gastritis to determine its value in identifying patients at high risk of gastric cancer. Gastric emptying was measured by the acetaminophen absorption method, and the extent of fundal gastritis was determined by the endoscopic Congo red test. The results showed that gastric emptying was significantly slower in patients with severe fundal gastritis than in those without. Gastric emptying in patients with differentiated a...

  13. Technology Solutions Case Study: Preventing Thermal Bypass

    Energy Technology Data Exchange (ETDEWEB)

    none,

    2012-10-01

    This project highlights the importance of continuous air barriers in full alignment with insulation to prevent thermal bypasses and achieve high energy performance, and recommends use of ENERGY STAR's Thermal Bypass Inspection Checklist.

  14. Nonselective digital subtraction angiography of aortocoronary bypasses

    International Nuclear Information System (INIS)

    Intra-arterial DSA was performed on 225 patients with a total of 552 coronary bypasses (515 aorto-coronary venous bypasses and 37 internal mammary artery bypasses). Four hundred and ninety-five bypasses were examined in the four weeks following surgery; of these, 428 (85.9%) were patent. Demonstration of the distal anastomosis was obtained in 40.4% of bypasses of the right anterior interventricular artery and in 36.1% of the right coronary artery, at least in their proximal parts. Bypasses of smaller branches showed filling in 12.8 to 19.2%. Because of the unsatisfactory demonstration of distal vessels by non-selective intra-arterial DSA, this method is suitable only for showing the patency of a bypass in the postoperative phase, but should not be used for investigating cardiac signs and symptoms following a bypass examination. (orig.)

  15. Gastric emptying in patients with gastric ulcer

    International Nuclear Information System (INIS)

    The estimated volume of meal in the stomach 30 mins after sup(113m)In-DTPA administration was determined in patients with gastric ulcer and normal controls by 1) relating counts in the stomach to those in the whole field of view of the gamma camera and 2) aspirations. In the normal controls there was no significant difference between the two methods but in the gastric ulcer patients, the gamma camera method predicted significantly more meal in the stomach than was recovered by aspiration. It was suggested that the large low lying stomach found in gastric ulcer disease causes extensive overlap of the small bowel and invalidates measurements of gastric emptying made by a gamma camera. (U.K.)

  16. Multimodality imaging of coronary artery bypass grafts

    OpenAIRE

    Salm, Liesbeth Pauline

    2006-01-01

    This thesis describes multiple imaging modalities to examine coronary artery bypass grafts, and the research which was performed to further develop noninvasive imaging techniques to detect stenoses in native coronary arteries and bypass grafts in patients who experienced recurrent chest pain after coronary artery bypass grafting (CABG).

  17. Treatment of gastric cancer

    OpenAIRE

    Orditura, Michele; Galizia, Gennaro; Sforza, Vincenzo; Gambardella, Valentina; Fabozzi, Alessio; Laterza, Maria Maddalena; Andreozzi, Francesca; Ventriglia, Jole; Savastano, Beatrice; MABILIA, ANDREA; Lieto, Eva; Ciardiello, Fortunato; De Vita, Ferdinando

    2014-01-01

    The authors focused on the current surgical treatment of resectable gastric cancer, and significance of peri- and post-operative chemo or chemoradiation. Gastric cancer is the 4th most commonly diagnosed cancer and the second leading cause of cancer death worldwide. Surgery remains the only curative therapy, while perioperative and adjuvant chemotherapy, as well as chemoradiation, can improve outcome of resectable gastric cancer with extended lymph node dissection. More than half of radically...

  18. Interventions in Infrainguinal Bypass Grafts

    International Nuclear Information System (INIS)

    The interventional radiologist plays an important role in the detection and prevention of infrainguinal bypass failure. Early detection and evaluation of flow-limiting lesions effectively preserve graft (venous bypass and polyester or expanded polytetrafluoroethylene bypass) patency by identifying stenoses before occlusion occurs. Delay in treatment of the at-risk graft may result in graft failure and a reduced chance of successful revascularization. For this reason, surveillance protocols form an important part of follow-up after infrainguinal bypass surgery. As well as having an understanding of the application of imaging techniques including ultrasound, MR angiography, CT angiography and digital subtraction angiography, the interventional radiologist should have detailed knowledge of the minimally invasive therapeutic options. Percutaneous transluminal angioplasty (PTA), or alternatively cutting balloon angioplasty, is the interventional treatment of choice in prevention of graft failure and occlusion. Further alternatives include metallic stent placement, fibrinolysis, and mechanical thrombectomy. Primary assisted patency rates following PTA can be up to 65% at 5 years. When the endovascular approach is unsuccessful, these therapeutic options are complemented by surgical procedures including vein patch revision, jump grafting, or placement of a new graft

  19. The influence of nutrients, biliary-pancreatic secretions, and systemic trophic hormones on intestinal adaptation in a Roux-en-Y bypass model

    DEFF Research Database (Denmark)

    Taqi, Esmaeel; Wallace, Laurie E; de Heuvel, Elaine;

    2010-01-01

    The signals that govern the upregulation of nutrient absorption (adaptation) after intestinal resection are not well understood. A Gastric Roux-en-Y bypass (GRYB) model was used to isolate the relative contributions of direct mucosal stimulation by nutrients, biliary-pancreatic secretions, and sy...

  20. Intraarterial digital subtraction angiography of aortofemoral bypasses

    International Nuclear Information System (INIS)

    In a retrospective study, 214 digital subtraction angiography (DSA) examinations of aortofemoral and femorocrural bypasses were reviewed. In 90% of cases intravenous DSA was diagnostic for aortofemoral bypasses, and in 95% of cases intrarterial DSA angiograms of excellent image quality were obtained. In 82% arterial stenoses proximal to the bypass, in 62% stenoses distal to the bypass, and in only 15% stenoses involving the bypass itself could be detected. In 54% the bypass was regularly perfused. In 26% a complete occlusion could be seen. All angiograms were obtained after infusion of the low-osmolar nonionic contrast medium Iopromide, 150mg/ml. All examinations were painless, and no heat-induced motion artifacts were registered. No disturbances of vital signs were observed. DSA with a nonionic low-osmolarity contrast medium (Iopromide) is a safe and reliable technique for the examination of all surgical aortofemoral bypasses

  1. Bypass materials in vascular surgery

    Directory of Open Access Journals (Sweden)

    Willich, Stephan N.

    2006-03-01

    Full Text Available Introduction: Arteriosclerotic changes can lead to circulatory disturbances in various areas of the human vascular system. In addition to pharmacological therapy and the management of risk factors (e. g. hypertension, diabetes, lipid metabolism disorders, and lifestyle, surgical interventions also play an important role in the treatment of arteriosclerosis. Long-segment arterial occlusions, in particular, can be treated successfully with bypass sur-gery. A number of different materials are available for this type of operation, such as autologous vein or pros-thetic grafts comprised of polytetrafluoroethylene (PTFE or Dacron®. Prosthetic materials are used especially in the treatment of peripheral artery disease, such as in aortoiliac or femoropopliteal bypass surgery. The present report will thus focus on this area in order to examine the effectiveness of different bypass materials. Among the efforts being made to refine the newly introduced DRG system in Germany, analysing the different bypass materials used in vascular surgery is particularly important. Indeed, in its current version the German DRG system does not distinguish between bypass materials in terms of reimbursement rates. Differences in cost structures are thus of especial interest to hospitals in their budget calculations, whereas both private and statutory health insurance funds are primarily interested in long-term results and their costs. Objectives: The goal of this HTA is to compare the different bypass materials used in vascular surgery in terms of their medical efficiency and cost-effectiveness, as well as with regard to their ethical, social and legal implications. In addition, this report aims to point out the areas in which further medical, epidemiological and health economic research is still needed. Methods: Relevant publications were identified by means of a structured search of databases accessed through the German Institute of Medical Documentation and Information

  2. Ivor-Lewis oesophagogastrectomy with Roux-en-Y duodenal bypass.

    Science.gov (United States)

    Cartwright, J; Forbat, E; Botha, A

    2016-02-01

    Oesophagectomies and gastrectomies are performed predominantly for the treatment of malignant disease. However, in this case series, we describe three patients with benign disease who had a laparoscopic oesophagogastrectomy with gastroduodenal detachment and Roux-en-Y biliary diversion, and discuss the operative feasibility and consequent patient outcomes. Our aim was to modify the procedure using an established reconstruction already practised in gastric and bariatric surgery, thereby preventing operative sequelae that lead to a poor quality of life (eg reflux oesophagitis and vomiting). During the first postoperative year, our first two patients experienced weight loss, indigestion and lower bowel symptoms with no apparent improvement in gastric function compared with a standard gastric tube pull-up reconstruction. In the longer term, in both patients, the gastric tube interpositions appeared to function well and there was no evidence of gastro-oesophageal reflux disease, delayed gastric emptying or troublesome indigestion. Our third patient, who had lifelong severe reflux symptoms, was eating normally three months after the operation with no need for antacid medication. We therefore conclude that laparoscopic Ivor-Lewis oesophagogastrectomy with Roux-en-Y bypass is a more complex reconstruction with added risks but may in the long term result in better overall outcomes and satisfaction for patients, particularly those with benign disease. PMID:26741669

  3. Gastric immature teratoma

    International Nuclear Information System (INIS)

    Gastric teratoma (GT) is a rare neoplasm which accounts for less than 1% of all teratomas in children. Little more than 100 cases of GT are reported in the literature out of which, about a dozen cases are of immature variety. We present a case of immature gastric teratoma in a 7-month-old male baby. (author)

  4. Epidemiology of gastric cancer

    Institute of Scientific and Technical Information of China (English)

    Katherine D Crew; Alfred I Neugut

    2006-01-01

    The incidence and mortality of gastric cancer have fallen dramatically in US and elsewhere over the past several decades. Nonetheless, gastric cancer remains a major public health issue as the fourth most common cancer and the second leading cause of cancer death worldwide. Demographic trends differ by tumor location and histology. While there has been a marked decline in distal, intestinal type gastric cancers, the incidence of proximal, diffuse type adenocarcinomas of the gastric cardia has been increasing, particularly in the Western countries. Incidence by tumor sub-site also varies widely based on geographic location, race, and socioeconomic status. Distal gastric cancer predominates in developing countries, among blacks, and in lower socioeconomic groups, whereas proximal tumors are more common in developed countries, among whites, and in higher socio-economic classes. Diverging trends in the incidence of gastric cancer by tumor location suggest that they may represent two diseases with different etiologies. The main risk factors for distal gastric cancer include Helicobacter pylori (H pylori) infection and dietary factors, whereas gastroesophageal reflux disease and obesity play important roles in the development of proximal stomach cancer. The purpose of this review is to examine the epidemiology and risk factors of gastric cancer, and to discuss strategies for primary prevention.

  5. "Gastric bascule": an unusual form of gastric volvulus.

    Science.gov (United States)

    Menezes, Amber; Sowerby, Leigh; Malthaner, Richard A; Parry, Neil G

    2010-03-01

    Gastric volvulus can occur along the organoaxial axis or the mesenteroaxial axis. We present a patient with a gastric bascule: a gastric volvulus due to two lead points. A 17-year-old boy with dextrogastria, asplenia, and left diaphragmatic eventration presented with acute onset of nonbilious emesis, jaundice, and diffuse abdominal tenderness. Surgical exploration demonstrated a gastric volvulus, with lead points of torsion at the gastroesophageal junction and the second part of the duodenum, causing biliary obstruction. After decompression, reduction, and gastropexy, the patient recovered well. Gastric bascule is a subtype of gastric volvulus, whereby two lead points cause gastric rotation and folding of the stomach upon itself. PMID:20172106

  6. Benign gastric filling defect

    International Nuclear Information System (INIS)

    The gastric lesion is a common source of complaints to Orientals, however, evaluation of gastric symptoms and laboratory examination offer little specific aid in the diagnosis of gastric diseases. Thus roentgenography of gastrointestinal tract is one of the most reliable method for detail diagnosis. On double contract study of stomach, gastric filling defect is mostly caused by malignant gastric cancer, however, other benign lesions can cause similar pictures which can be successfully treated by surgery. 66 cases of benign causes of gastric filling defect were analyzed at this point of view, which was verified pathologically by endoscope or surgery during recent 7 years in Yensei University College of Medicine, Severance Hospital. The characteristic radiological picture of each disease was discussed for precise radiologic diagnosis. 1. Of total 66 cases, there were 52 cases of benign gastric tumor 10 cases of gastric varices, 5 cases of gastric bezoar, 5 cases of corrosive gastritis, 3 cases of granulomatous disease and one case of gastric hematoma. 2. The most frequent causes of benign tumors were adenomatous polyp (35/42) and the next was leiomyoma (4/42). Others were one of case of carcinoid, neurofibroma and cyst. 3. Characteristic of benign adenomatous polyp were relatively small in size, smooth surface and were observed that large size, benign polyp was frequently type IV lesion with a stalk. 4. Submucosal tumors such as leiomyoma needed differential diagnosis with polypoid malignant cancer. However, the characteristic points of differentiation was well circumscribed smooth margined filling defect without definite mucosal destruction on surface. 5. Gastric varices showed multiple lobulated filling defected especially on gastric fundus that changed its size and shape by respiration and posture of patients. Same varices lesions on esophagus and history of liver disease were helpful for easier diagnosis. 6. Gastric bezoar showed well defined movable mass

  7. Treatment of gastric cancer

    Science.gov (United States)

    Orditura, Michele; Galizia, Gennaro; Sforza, Vincenzo; Gambardella, Valentina; Fabozzi, Alessio; Laterza, Maria Maddalena; Andreozzi, Francesca; Ventriglia, Jole; Savastano, Beatrice; Mabilia, Andrea; Lieto, Eva; Ciardiello, Fortunato; De Vita, Ferdinando

    2014-01-01

    The authors focused on the current surgical treatment of resectable gastric cancer, and significance of peri- and post-operative chemo or chemoradiation. Gastric cancer is the 4th most commonly diagnosed cancer and the second leading cause of cancer death worldwide. Surgery remains the only curative therapy, while perioperative and adjuvant chemotherapy, as well as chemoradiation, can improve outcome of resectable gastric cancer with extended lymph node dissection. More than half of radically resected gastric cancer patients relapse locally or with distant metastases, or receive the diagnosis of gastric cancer when tumor is disseminated; therefore, median survival rarely exceeds 12 mo, and 5-years survival is less than 10%. Cisplatin and fluoropyrimidine-based chemotherapy, with addition of trastuzumab in human epidermal growth factor receptor 2 positive patients, is the widely used treatment in stage IV patients fit for chemotherapy. Recent evidence supports the use of second-line chemotherapy after progression in patients with good performance status PMID:24587643

  8. Gastric Necrosis due to Acute Massive Gastric Dilatation

    Directory of Open Access Journals (Sweden)

    Ibrahim Aydin

    2013-01-01

    Full Text Available Gastric necrosis due to acute massive gastric dilatation is relatively rare. Vascular reasons, herniation, volvulus, acute gastric dilatation, anorexia, and bulimia nervosa play a role in the etiology of the disease. Early diagnosis and treatment are highly important as the associated morbidity and mortality rates are high. In this case report, we present a case of gastric necrosis due to acute gastric dilatation accompanied with the relevant literature.

  9. Effects of Roux-en-Y gastric bypass surgery on glucose and lipid metabolism and systemic inflammation level in zucker diabetic fatty rats%Roux-en-Y胃旁路术对肥胖糖尿病大鼠糖脂代谢及炎症水平的影响

    Institute of Scientific and Technical Information of China (English)

    郭妍; 刘超乾; 单成祥; 张誉籍; 范志雄; 邹大进

    2014-01-01

    依赖于摄食量减少.%Objective To investigate the effect of Roux-en-Y gastric bypass (RYGB) on glucose and lipid metabolism and systemic inflammation levels in spontaneous Zucker Diabetic Fatty (ZDF) rats.Methods Thirty male ZDF rats were randomly divided to three groups: RYGB surgery group (n =10),sham surgery pair-fed (PF) group (n =10) and sham surgery ad libitum fed (AL) group (n =10).Body weight,food intake was monitored.Oral glucose tolerance test,serum lipid level,liver transaminases,TNF-α,IL-1 β and MCP-1 were measured before and 10-week after surgery.Then,rats were sacrificed.The epididymal fat were taken from all groups of rats.The mRNA expression of TNF-α,IL-1 β and MCP-1 in epididymal fat of rats were detected using RT-PCR method.The data was analyzed by t test and analysis of variance.Result Oral glucose tolerance test showed that blood glucose were significantly different among the RYGB group,AL group and PF group after 10 weeks postoperatively (FPG (6.8 ± 0.5),(8.7 ± 2.2),(20.6 ±3.0) mmol/L,F=12.4,P<0.05,30 min (14.0 ±0.8),(19.1 ±4.3),(31.7 ±0.9) mmol/L,F=20.1,P<0.05,60 min (15.4±1.1),(20.2 ±7.1),(33.0±0.3) mmol/L,F=22.5,P<0.05,90min (13.2 ±0.6),(20.0 ±5.8),(32.4 ±0.4) mmol/L,F =14.7,P <0.05,120 min (8.3 ±0.3),(14.0 ± 5.2),(29.1 ± 1.2) mmol/L,F =20.5,P < 0.05).Serum total cholesterol (TC) and free fatty acids (FFA) was decreased in the RYGB group,compared with PF and AL controls (TC (3.82 ± 0.13) vs (4.10±0.37) vs (5.25 ±0.25) mmol/L,F=15.3,FFA (0.47 ±0.14) vs (0.93 ±0.08) vs (0.78 ±0.06) mmol/L,F =3.4,both P < 0.05).And liver transaminases (ALT and AST) levels in RYGB group were lower than AL group,but higher than PF group (ALT (129 ±28) vs (67 ±7) vs (726 ± 160) mmol/L,F =15.1,AST (208±26) vs (124±10) vs (673±209) mmol/L,F=5.9,bothP<0.05) and the serum levels of TNF-α and IL-1 βin RYGB group also decreased,compared with those in AL group (TNF-α (124 ± 23) vs (532 ± 52) mmol/L,t =5.8 ; IL-1 β (61 ± 16) vs (250 ± 32) mmol/L,t =4

  10. Mini cardiopulmonary bypass: Anesthetic considerations

    OpenAIRE

    Alsatli, Raed A.

    2012-01-01

    This review article is going to elaborate on the description, components, and advantages of mini-cardiopulmonary bypass (mini-CPB), with special reference to the anesthetic management and fast track anesthesia with mini-CPB. There are several clinical advantages of mini-CPB like, reduced inflammatory reaction to the pump, reduced need for allogenic blood transfusion and lower incidence of postoperative neurological complications. There are certainly important points that have to be considered...

  11. Gastric emptying in morbid obesity

    International Nuclear Information System (INIS)

    Weight loss following gastroplasty had no correlation with gastric emptying rate. Patients who showed transient prolongation of gastric emptying returned to normal one year later and showed no significant difference in weight loss from those who did not have temporary delayed gastric emptying. Perhaps gatroplasty (at least temporarily) reduces the gastric volume producing early satiation without affecting the gastric emptying rate as tested by a small volume radiolabelled test meal. Longer follow-up is indicated to see if delayed weight gain occurs because of gastric pouch stretching and if this has any correlation with gastric emptying rate. (Author)

  12. Tests of gastric neuromuscular function.

    Science.gov (United States)

    Parkman, Henry P; Jones, Michael P

    2009-05-01

    Tests of gastric neuromuscular function are used to evaluate patients with symptoms referable to the upper digestive tract. These symptoms can be associated with alterations in the rates of gastric emptying, impaired accommodation, heightened gastric sensation, or alterations in gastric myoelectrical function and contractility. Management of gastric neuromuscular disorders requires an understanding of pathophysiology and treatment options as well as the appropriate use and interpretation of diagnostic tests. These tests include measures of gastric emptying; contractility; electrical activity; regional gastric motility of the fundus, antrum, and pylorus; and tests of sensation and compliance. Tests are also being developed to improve our understanding of the afferent sensory pathways from the stomach to the central nervous system that mediate gastric sensation in health and gastric disorders. This article reviews tests of gastric function and provides a basic description of the tests, the methodologies behind them, descriptions of the physiology that they assess, and their clinical utility. PMID:19293005

  13. Epicardial ultrasound in coronary artery bypass surgery

    OpenAIRE

    Budde, R.P.J.

    2005-01-01

    Chapter 1 Coronary artery bypass surgery (CABG) is traditionally performed via a median sternotomy approach on cardiopulmonary bypass (arrested heart). Since the mid 1990ties, beating heart, minimally invasive and even totally endoscopic CABG are (re)explored. In all approaches to CABG, the surgeon may face several intraoperative difficulties: 1. Localization of the target coronary artery for bypass grafting. 2. Selection of the optimal anastomotic site on the target coronary artery. 3. Asses...

  14. Hereditary diffuse gastric cancer

    DEFF Research Database (Denmark)

    van der Post, Rachel S; Vogelaar, Ingrid P; Carneiro, Fátima;

    2015-01-01

    Germline CDH1 mutations confer a high lifetime risk of developing diffuse gastric (DGC) and lobular breast cancer (LBC). A multidisciplinary workshop was organised to discuss genetic testing, surgery, surveillance strategies, pathology reporting and the patient's perspective on multiple aspects...

  15. Gastric volvulus in childhood.

    Directory of Open Access Journals (Sweden)

    Karande T

    1997-04-01

    Full Text Available Gastric volvulus is an uncommon condition more so in the paediatric age group. The cause of gastric volvulus may be idiopathic or secondary to various congenital or acquired conditions. In this short series of three patients, one had volvulus which was due to ligamentous laxity and mobile spleen, second had congenital postero-lateral diaphragmatic defect and the third had hiatus hernia.

  16. Diet and gastric cancer

    OpenAIRE

    Šipetić Sandra B.; Tomić-Kundaković Slađana; Vlajinac Hristina D.; Janković Slavenka M.; Marinković Jelena M.; Maksimović Jadranka M.

    2003-01-01

    The aim of this case-control study, conducted in Serbia during the period 1998-2000, was to investigate whether diet was associated with the development of gastric cancer. The case group consisted of 131 patients with histologically confirmed gastric cancer, and the control group of 131 patients with orthopedics diseases and injuries. Cases and controls were individually matched by age (±± 2 years), gender, and place of residence. On the basis of multivariate logistic regression analysis, fol...

  17. Operative Complications During Pregnancy After Gastric Bypass—a Register-Based Cohort Study

    DEFF Research Database (Denmark)

    Andreasen, Lisbeth A; Nilas, Lisbeth; Kjær, Mette M

    2014-01-01

    BACKGROUND: Late complications to bariatric surgery during pregnancy have become an area of concern. Expansion of the uterus and the following displacement of the small intestine may increase the risk of internal herniation. We wanted to estimate the risk and consequences of surgical complications...... during pregnancy in a national cohort of women with a history of gastric bypass surgery. METHODS: A national, register-based cohort study of all Danish women with a history of gastric bypass surgery who had given birth from 2004 to 2010 was conducted. Surgical codes registered during pregnancy and until...... puerperium. CONCLUSIONS: The incidence of internal herniation during pregnancy was 1 % in our study. Internal herniation may be a serious complication in pregnant women, and both the diagnosis and treatment requires handling by experienced obstetrical, radiological, and surgical staff....

  18. Anti-obesity effect of extract from fermented Curcuma longa L. through regulation of adipogenesis and lipolysis pathway in high-fat diet-induced obese rats

    Directory of Open Access Journals (Sweden)

    Ji Hye Kim

    2016-01-01

    Full Text Available Background: Even though Curcuma longa L. possesses various biological activities, it has strong flavor and taste, which decrease consumer palatability and limit industrial applications in food. Objective: The present study investigates the effects of C. longa L. fermented with Aspergillus oryzae supplementation in 60% high-fat diet-induced obese rats measured by the activation of adipogenesis and lipolysis. Design: Rats were divided into four groups (n=6 per group after 1 week of acclimatization: a normal diet group comprised rats fed the AIN76A rodent diet; a high-fat diet-induced obese group with rats fed a 60% high-fat diet; a Garcinia cambogia treated group (positive control with rats fed a 60% high-fat diet with G. cambogia 500 g/kg body weight (b.w./day; and an fermented C. longa L. 50% ethanolic extract treated group (FCE50 with rats fed a 60% high-fat diet with FCE50 500 g/kg b.w./day. Each group received the appropriate vehicle or sample daily by gastric intubation for 12 weeks. Results: We found that FCE50 administration suppressed b.w. gain and reduced white adipose tissue weight, serum triglyceride (TG, and cholesterol in high-fat diet-induced obese rats. These results can be associated with the suppression of adipocyte differentiation and lipogenesis with a decrease in the mRNA expressions of fatty acid synthase, acetyl-CoA carboxylase, adipocyte protein 2, and lipoprotein lipase induced by FCE50 administration. In addition, FCE50 increased lipolysis and β-oxidation by up-regulating the expression of lipases such as adipose triglyceride lipase, hormone-sensitive lipase, adiponectin, and AMP-activated protein kinase. Conclusions: These results suggest that FCE50 can be a candidate for the prevention of obesity via suppressing adipogenesis and promoting lipolysis.

  19. TECAB - Totally Endoscopic Coronary Artery Bypass

    Medline Plus

    Full Text Available ... And the bypass vessel is the so-called “internal mammary artery.” That’s an artery, as opposed to ... you very much. -- while I’m preparing the internal mammary artery for bypass. Good. All right. We ...

  20. Epicardial ultrasound in coronary artery bypass surgery

    NARCIS (Netherlands)

    Budde, R.P.J.

    2005-01-01

    Chapter 1 Coronary artery bypass surgery (CABG) is traditionally performed via a median sternotomy approach on cardiopulmonary bypass (arrested heart). Since the mid 1990ties, beating heart, minimally invasive and even totally endoscopic CABG are (re)explored. In all approaches to CABG, the surgeo

  1. TECAB - Totally Endoscopic Coronary Artery Bypass

    Medline Plus

    Full Text Available ... as doctors use for this operation is “TECAB,” meaning “Totally Endoscopic Coronary Artery Bypass.” This procedure will ... make sure his vessels are able for bypass, meaning doing the CT angiograph for the peripheral arteries. ...

  2. Atrial fibrillation post cardiac bypass surgery

    OpenAIRE

    Mostafa, Ashraf; EL-Haddad, Mohamed A.; Shenoy, Maithili; Tuliani, Tushar

    2012-01-01

    Atrial fibrillation occurs in 5-40% patients after coronary artery bypass graft surgery. Atrial fibrillation increases mortality and morbidity in the post-operative period. We sought to conduct a comprehensive review of literature focusing on pathophysiology, risk factors, prevention and treatment of post coronary artery bypass graft atrial fibrillation.

  3. TECAB - Totally Endoscopic Coronary Artery Bypass

    Medline Plus

    Full Text Available ... going to thread that up to the patient’s bypass graft using X-ray, and there you are. So what we’re going to do is manipulate this catheter into actually the artery that leads to the arm, the subclavian, which is where the bypass comes off. Let me just saw it for ...

  4. Gastric volvulus with partial and complete gastric necrosis

    Directory of Open Access Journals (Sweden)

    Ram Mohan Shukla

    2014-01-01

    Full Text Available Here, we report two interesting cases of gastric necrosis in acute gastric volvulus due to eventration of the diaphragm. Both the cases presented with a significant challenge and were managed successfully. The management of the cases is presented and relevant literature is discussed. To the best of our knowledge, this is the first case report of gastric volvulus with gastric necrosis requiring complete and partial gastrectomy in the available English literature.

  5. Gastric volvulus with partial and complete gastric necrosis.

    Science.gov (United States)

    Shukla, Ram Mohan; Mandal, Kartik Chandra; Maitra, Sujay; Ray, Amit; Sarkar, Ruchirendu; Mukhopadhyay, Biswanath; Bhattacharya, Malay

    2014-01-01

    Here, we report two interesting cases of gastric necrosis in acute gastric volvulus due to eventration of the diaphragm. Both the cases presented with a significant challenge and were managed successfully. The management of the cases is presented and relevant literature is discussed. To the best of our knowledge, this is the first case report of gastric volvulus with gastric necrosis requiring complete and partial gastrectomy in the available English literature. PMID:24604987

  6. Gastric volvulus with partial and complete gastric necrosis

    OpenAIRE

    Ram Mohan Shukla; Kartik Chandra Mandal; Sujay Maitra; Amit Ray; Ruchirendu Sarkar; Biswanath Mukhopadhyay; Malay Bhattacharya

    2014-01-01

    Here, we report two interesting cases of gastric necrosis in acute gastric volvulus due to eventration of the diaphragm. Both the cases presented with a significant challenge and were managed successfully. The management of the cases is presented and relevant literature is discussed. To the best of our knowledge, this is the first case report of gastric volvulus with gastric necrosis requiring complete and partial gastrectomy in the available English literature.

  7. Gastric cancer and trastuzumab: first biologic therapy in gastric cancer

    OpenAIRE

    Gunturu, Krishna S; Woo, Yanghee; Beaubier, Nike; Remotti, Helen E.; Saif, M. Wasif

    2013-01-01

    Gastric cancer remains difficult to cure and has a poor overall prognosis. Chemotherapy and multimodality therapy has shown some benefit in the treatment of gastric cancer. Current therapies for gastric cancer have their limitations; thus, we are in need of newer treatment options including targeted therapies. Here, we review the biologic therapy with trastuzumab in human epidermal growth factor receptor 2 (HER2)+ gastric cancer.

  8. Gastroscopic treatment of gastric band penetrating the gastric wall

    DEFF Research Database (Denmark)

    Jess, Per; Fonnest, G

    1999-01-01

    Gastric wall penetration of a gastric band after operation for morbid obesity is a well known late complication. The treatment is usually reoperation. In this case report we show that a band penetrating the gastric wall can be successfully treated by gastroscopic operation. This technique is more...... simple than reoperation, especially in case of morbid obesity at the time of the complication....

  9. The gastric cancer

    Directory of Open Access Journals (Sweden)

    Pelayo Correa

    2013-09-01

    Full Text Available Gastric cancer ranks fourth in incidence and second in mortality among all cancers worldwide. Despite the decrease in incidencein some regions of the world, gastric cancer continues to present a major clinical challenge due to most cases beingdiagnosed in advanced stages with poor prognosis and limited treatment options. The development of gastric cancer is acomplex and multi-factored process involving a number of etiological factors and multiple genetic and epigenetic alterations.Among the predisposing factors are: Helicobacter pylori infection, high salt intake, smoking, and, in a small percentage ofpatients, a family genetic component. More than 90% of stomach cancers are adenocarcinomas, which are classified intotwo major histological groups: intestinal and diffuse. Intestinal adenocarcinoma is preceded by a sequence of gastric lesionsknown as Correa´s cascade. According to the anatomical position, adenocarcinomas are classified as proximal (originatingin the cardia and distal (originating in the body and antrum. This is a classification that recognizes two different clinicalentities. In general, the only possible cure for the disease is resection of the tumor in an early stage for which the identificationand monitoring of at-risk patients play a significant role. With the exception of Japan, no effective early detection programsexist. Anti-H. pylori has been shown to be an effective measure in the prevention of gastric cancer.

  10. In situ bypass og diabetes

    DEFF Research Database (Denmark)

    Jensen, Leif Panduro; Schroeder, T V; Lorentzen, J E

    1993-01-01

    From 1986 through to 1990 a total of 483 in situ bypass procedures were performed in 444 patients. Preoperative risk-factors were equally distributed among diabetic (DM) and non-diabetic (NDM) patients, except for smoking habits (DM:48%, NDM:64%, p = 0.002) and cardiac disease (DM:45%, NDM:29%, p...... = 0.005). Critical limb-ischaemia was more often present in diabetic than non-diabetic patients (DM:57%, NDM:36%, p = 0.0002). Diabetic patients had a significantly lower distal anastomosis than non-diabetic patients (p = 0.00001). There were no differences among diabetic and non-diabetic patients...... regarding three years primary and secondary patency (58% and 64% respectively), and regarding major amputations. However, the rate of minor amputations was higher in insulin-dependent compared with non-insulin-dependent diabetics, who in turn had a higher rate than non-diabetics (p

  11. ANTIGEN MG7 IN GASTRIC CANCER AND GASTRIC PRECANCEROUS LESIONS

    Institute of Scientific and Technical Information of China (English)

    郭冬丽; 宁佩芳; 袁媛

    2004-01-01

    Objective: To study the dynamic change and its diagnostic significance of MG7 expression in the process of gastric cancer development. Methods: The expression level of antigen MG7 was determined by immunohistochemistry method in 406 cases of gastric mucosa. The classification of intestinal metaplasia of gastric mucosa was determined by histochemistry method in 82 cases. Results: The positive rate of MG7 expression in normal gastric mucosa, intestinal metaplasia and dysplasia of gastric mucosa and gastric cancer were increased gradually (P<0.01). The positive rate of MG7 expression in superficial gastritis, atrophic gastritis and gastric cancer were increased on sequence (P<0.01). The positive rate of antigen MG7 expression in type Ⅲ intestinal metaplasia of gastric mucosa had significant difference,compared with that in type Ⅰ an Ⅱ intestinal metaplasia (P<0.05). Conclusion: MG7 antigen had close relationship with gastric cancer. Type Ⅲ intestinal metaplasia, atrophic gastritis and dysplasia should be followed up in order to improve the early detection of gastric cancer. MG7 antigen had great clinical value in the dynamic follow-up of gastric precursors.

  12. Secondary coolant purification system with demineralizer bypass

    International Nuclear Information System (INIS)

    Apparatus and method are provided for a nuclear stream supply system for adequately controlling the chemistry of the secondary coolant. The invention includes means for the addition of volatile chemicals, a full flow condensate demineralizer, continuous blowdown capability, radiation detection means, a condensate demineralizer bypass line, and an auxiliary demineralizer bypass line, and an auxiliary demineralizer sized to handle full blowdown flow. The auxiliary demineralizer is cut into the system and the steam generator feedwater flow is bypassed around the full flow condensate demineralizer whenever radioactivity is detected in the secondary coolant

  13. Effects of gastric pacing on gastric emptying and plasma motilin

    Institute of Scientific and Technical Information of China (English)

    Min Yang; Dian-Chun Fang; Qian-Wei Li; Nian-Xu Sun; Qing-Lin Long; Jian-Feng Sui; Lu Gan

    2004-01-01

    AIM: To invertigate the effects of gastric pacing on gastric emptying and plasma motilin level in a canine model of gastric motility disorders and the correlation between gastric emptying and plasma motilin level.METHODS: Ten healthy Mongrel dogs were divided into:experimental group of six dogs and control group of four dogs. A model of gastric motility disorders was established in the experimental group undergone truncal vagotomy combined with injection of glucagon. Gastric half-emptying time (GEt1/2) was monitored with single photon emission computerized tomography (SPECT), and the half-solid test meal was labeled with an isotope-99m Tc sulfur colloid. Plasma motilin concentration was measured with radioimmunoassay (RIA) kit. Surface gastric pacing at 1.1-1.2 times the intrinsic slow-wave frequency and a superimposed series of high frequency pulses (10-30 Hz) was performed for 45 min daily for a month in conscious dogs.RESULTS: After surgery, GEt1/2 in dogs undergone truncal vagotomy was increased significantly from 56.35±2.99 min to 79.42±l.91 min (P<0.001), but surface gastric pacing markedly accelerated gastric emptying and significantly decreased GEt1/2 to 64,94±l.75 min (P<0.001) in animals undergone vagotomy. There was a significant increase of plasma level of motilin at the phase of IMCⅢ (interdigertive myoelectrical complex, IMCⅢ) in the dogs undergone bilateral truncal vagotomy (baseline vs vagotomy, 184.29±9.81 pg/ml vs 242.09±17,22 pg/ml; P<0.01). But plasma motilin concentration (212.55±11.20 pg/ml; P<0.02) was decreased significantly after a long-term treatment with gastric pacing.Before gastric pacing, GEt1/2 and plasma motilin concentration of the dogs undergone vagotomy showed a positive correlation (r=0.867, P<0.01), but after a long-term gastric pacing, GEt1/2 and motilin level showed a negative correlation (r=-0.733, P<0,04).CONCLUSION: Surface gastric pacing with optimal pacing parameters can improve gastric emptying

  14. TECAB - Totally Endoscopic Coronary Artery Bypass

    Medline Plus

    Full Text Available ... perfect bypass. We are often asked how you learn this. Important question. Hours and hours of suturing ... OR-Live” makes it easy for you to learn more. Just click on the “Request information” button ...

  15. TECAB - Totally Endoscopic Coronary Artery Bypass

    Medline Plus

    Full Text Available ... Artery Bypass June 10, 2009 Welcome to the University of Maryland Medical Center in Baltimore, where you ... to Maryland. Welcome to Baltimore. Welcome to the University of Maryland Medical Center here in OR-26. ...

  16. TECAB - Totally Endoscopic Coronary Artery Bypass

    Medline Plus

    Full Text Available ... on for coronary surgery. A very durable bypass running here and supplying the chest wall with blood. ... case the branch, the typical branch that is running between the two heart chambers is located more ...

  17. TECAB - Totally Endoscopic Coronary Artery Bypass

    Medline Plus

    Full Text Available ... is pulsating behind the fascia. Here is some muscle. Here we have the apex or tip of ... tissue. It then turns into the transverse thoracic muscle here. This bypass vessel has an extremely long ...

  18. TECAB - Totally Endoscopic Coronary Artery Bypass

    Medline Plus

    Full Text Available ... sure that we preserve this bypass vessel very well in order to achieve this. So I go ... French quick-draw Venus cardiac visions cannula as well, which will draw back, go to the heart- ...

  19. Types of Coronary Artery Bypass Grafting

    Science.gov (United States)

    ... best option for you based on your needs. Traditional Coronary Artery Bypass Grafting Traditional CABG is used when at least one major ... Grafting This type of CABG is similar to traditional CABG because the chest bone is opened to ...

  20. Exhaust gas bypass valve control for thermoelectric generator

    Science.gov (United States)

    Reynolds, Michael G; Yang, Jihui; Meisner, Greogry P.; Stabler, Francis R.; De Bock, Hendrik Pieter Jacobus; Anderson, Todd Alan

    2012-09-04

    A method of controlling engine exhaust flow through at least one of an exhaust bypass and a thermoelectric device via a bypass valve is provided. The method includes: determining a mass flow of exhaust exiting an engine; determining a desired exhaust pressure based on the mass flow of exhaust; comparing the desired exhaust pressure to a determined exhaust pressure; and determining a bypass valve control value based on the comparing, wherein the bypass valve control value is used to control the bypass valve.