共查询到20条相似文献,搜索用时 31 毫秒
1.
Non-invasive monitoring of kidney allograft rejection through IDO metabolism evaluation 总被引:4,自引:0,他引:4
Brandacher G Cakar F Winkler C Schneeberger S Obrist P Bösmüller C Werner-Felmayer G Werner ER Bonatti H Margreiter R Fuchs D 《Kidney international》2007,71(1):60-67
The immunomodulatory enzyme indoleamine 2,3-dioxygenase (IDO) is activated by interferon-gamma (IFN-gamma) and via tryptophan depletion, suppresses adaptive T cell-mediated immunity in inflammation, host immune defense, and maternal tolerance. Its role in solid organ transplantation is still unclear. Therefore, we investigated the usefulness of IDO-mediated tryptophan catabolism in the evaluation of kidney allograft rejection. Blood, urine, and tissue samples were collected from 34 renal transplant patients without rejection and from nine patients with biopsy-confirmed episodes of acute rejection (n=12). Concentrations of kynurenine and tryptophan in serum and urine were analyzed by high-pressure liquid chromatography. Kynurenine to tryptophan ratio (kyn/trp) was calculated to estimate IDO activity. Immunostaining for IDO was performed on renal biopsies. Neopterin was assessed using radioimmunoassay. Kyn/trp and neopterin were detectable at low levels in serum of healthy volunteers and were increased in non-rejecting allograft recipients. Serum levels of kyn/trp were higher in recipients with rejection compared to non-rejectors as early as by day 1 post-surgery. Rejection episodes occurring within 13+/-5.9 days after transplantation were accompanied by elevated kyn/trp in serum (114+/-44.5 micromol/mmol, P=0.001) and urine (126+/-65.9 micromol/mmol, P=0.02) compared to levels during stable graft function. Kyn/trp correlated significantly with neopterin suggesting an IFN-gamma-induced increase in IDO activity. Immunostaining showed upregulation of IDO in rejection biopsies, localized in tubular-epithelial cells. Non-rejected grafts displayed no IDO expression. Acute rejection is associated with simultaneously increased serum and urinary kyn/trp in patients after kidney transplantation. Thus, IDO activity might offer a novel non-invasive means of immunomonitoring of renal allografts. 相似文献
2.
G. Cournot-Witmer A. Bourdeau M. Lieberherr C. L. Thil J. J. Plachot G. Enault R. Bourdon S. Balsan 《Calcified tissue international》1987,40(5):270-275
Summary Gallium nitrate (GaN) reduces cancer-related hypercalcemia and inhibits bone resorptionin vitro. This study investigated the effects of chronic GaN administration on bone, kidney, and parathyroid gland activity of growing
rats. Experimental animals received GaN (1.75 mg elemental gallium i.p. QOD×8, Ga+), and controls received the solvent (Ga−). In the bone of Ga+ rats the number of osteoclasts was increased (Ga+: 70.4±2.31 osteoclasts/mm2; Ga−: 46.5±1.61 osteoclasts/mm2,P<0.001), and apposition rate and osteoid width were unchanged. Ga was concentrated in bone (2.4 μmol/g cortical bone) and
detected by electron microprobe on the surface of a few trabeculae. Alkaline (Alp) and acid (Acp) phosphatase activities were
higher in Ga+ than in Ga− calvaria (Ga+: Alp 223±23.4 U/mg prot, Ga−: Alp 145±13.3 U/mg prot,P<0.02; Ga+: Acp 69.5±4.7 U/mg prot, Ga−: 57.5±2.8 U/mg prot,P<0.05). Serum iPTH was increased (Ga+: 112.9±17.6 pg/ml, Ga−: 41.4±7.4 pg/ml,P<0.01), serum calcium was reduced (Ga+: 2.4±0.02 mmol/l, Ga−: 2.6±0.03 mmol/l,P<0.001); calciuria remained comparable to controls. Relative to the hypocalcemia this suggests renal loss of Ca. The calcemic
response to hPTH 1-34 (i.v. 50 μ/kg) was decreased 2 hours after injection of the hormone (ΔCa: TPTX Ga+: 0.11±0.04 mmol/l, Ga−: 0.33 ±0.03 mmol/lP<0.01). In conclusion, Ga, at the dosage used, does not inhibit the activity of osteoblasts in rats and does not interfere
with mineralization but increases the number of osteoclasts through stimulation of parathyroid gland activity, induced by
a fall in serum calcium. The hypocalcemia seems to be related to skeletal resistance to PTH and to increased renal calcium
loss. 相似文献
3.
Castagneto M De Gaetano A Mingrone G Tacchino R Nanni G Capristo E Benedetti G Tataranni PA Greco AV 《Obesity surgery》1994,4(2):161-168
Insulin resistance is a common feature in obese patients. To evaluate the modifications in insulin sensitivity after a bariatric
operation such as Bilio-pancreatic diversion (BPD), three groups of subjects (14 normal controls (N); seven eX-obese patients
(X) with at least 2 years at weight-stable conditions after BPD surgery; and eight morbidly obese patients (O)) were studied
with intravenous (IVGTT) and oral (OGTT) glucose tolerance tests. The ratio of the area under the curve (AUC) for glucose
over that of insulin was used as a measure of insulin sensitivity. All the following tests were conducted as Bonferroni-corrected
pairwise t-tests, in case overall ANOVA was significant. No significant difference was found between N and X subjects, while obese patients
showed a reduced AUCg/AUCi ratio with respect to the normal controls (O vs N: 0.01164 ± 0.00039 vs 0.02392 ± 0.0039, p < 0.05). IVGTT, AUCs: significant differences were found in each case: N vs X: 0.0591 ± 0.0075 vs 0.1402 ± 0.0399, p < 0.05; N vs O: 0.0591 ± 0.0075 vs 0.0223 ± 0.0031, p < 0.01; X vs O: 0.1402 ± 0.0399 vs 0.0223 ± 0.0031, p < 0.05. IVGTT-derived data were also analyzed using the minimal model of glucose kinetics; with this method, glucose effectiveness
was significantly different between normal subject and obese subjects (0.0248 ± 0.00288 vs 0.00905 ± 0.00135 per min, p < 0.001). The insulin sensitivity index was not significantly different between normal and ex-obese subjects, while both
of these groups were significantly different from obese patients (N vs O: 12.04 × 10−5 ± 2.61 × 10−5 vs 3.29 × 10−5 ± 0.61 × 10−5, p < 0.066; X vs O: 16.42 × 10−5 ± 4.23 × 10−5 vs 3.29 × 10−5 ± 0.61 × 10−5 per min per pM, p < 0.02). In conclusion, the present study indicates that, after a body weight reduction operation capable of almost re-establishing
ideal body weight like BPD, obese individuals with a family history of obesity show a normalization of insulin response to
glucose load. 相似文献
4.
Melissas J Kontakis G Volakakis E Tsepetis T Alegakis A Hadjipavlou A 《Obesity surgery》2005,15(3):378-381
Background: Although low back (LBP) pain is not a lifethreatening disease, it is a source of significant discomfort and disability
and accounts for work absences. It has been shown previously that morbid obesity is associated with increased frequency of
LBP and that surgical weight loss improves the symptomatology. However, there are no studies to quantitatively assess the
exact degree of functional disability caused by severe obesity and the degree of improvement of LBP that follows weight loss
from bariatric surgery. Methods: 29 morbidly obese candidates for bariatric surgery with LBP, weight 132.5±27 (mean±SD) kg
and BMI 47.2±8.8 kg/m2 were examined for their functional status using psychometric instruments specifically designed to objectively assess the
patients' complaints. The preoperative scores were measured by a) visual analogue scales (VAS1, VAS2, VAS3), b) Roland-Morris
disability questionnaire, c) Oswestry LBP disability questionnaire, and d) Waddell disability index, and were compared with
the scores obtained by the same instruments 2 years after vertical banded gastroplasty. Results: The postoperative weight
(92.3±19 kg) and BMI (32.9±6.3 kg/m2) of the 29 patients were significantly reduced (P<0.001). The improved functional disability scores were statistically significant: a) VAS1 1.59±1.86 (mean±SD) vs 0.32±0.64,
P<0.001; b) VAS2 5.5±1.97 vs 2.14±1.88, P<0.001; c) VAS3 0.77±1.11 vs 0.09±0.29, P=0.006, d) Roland-Morris 7.89±5.11 vs 1.89±2.13, P<0.001; e) Oswestry 21.22±15.63 vs 5.61±7.51, P<0.001; f) Waddell 2.81±1.37 vs 0.56±0.72, P<0.001. Conclusions: Surgical weight loss significantly improves the degree of functional disability of morbidly obese patients
suffering from LBP. 相似文献
5.
Dale S. Bond Hollie A. Raynor Sivamainthan Vithiananthan Harry C. Sax Dieter Pohl G. D. Roye Beth A. Ryder Rena R. Wing 《Obesity surgery》2009,19(7):873-878
Background Previous studies show that slower habituation to taste stimuli is associated with reduced rates of satiation and greater energy
intake. This study compared rates of salivary habituation to gustatory presentations of lemon juice in 34 severely obese bariatric
surgery candidates [48.8 ± 7.9 years, 85% female, body mass index (BMI) = 47.4 ± 7.5 kg/m2] and 18 normal-weight controls (48.4 ± 9.5 years, 88.9% female, BMI = 22.7 ± 1.2 kg/m2).
Methods Parotid saliva was collected from cotton rolls positioned in the oral cavity during two baseline water trials and ten lemon
juice trials. Data were condensed into trial blocks, representing mean values for the two baseline water trials and each of
five pairs of lemon juice trials (i.e., blocks 1–5). Salivary change across lemon juice trials was calculated by subtracting
values for blocks 1 through 5 from baseline.
Results A significant interaction of group (bariatric surgery candidates/normal-weight controls) by blocked trials [F (4, 200) = 3.0; p < 0.05] indicated that the groups differed in their pattern of salivary responding, with bariatric surgery candidates’ salivation
(grams) failing to decrease significantly over the five blocked trials (−0.47 ± 0.18, p = 0.12), unlike that of the normal-weight controls (−1.30 ± 0.25, p < 0.001).
Conclusion These findings suggest that severely obese participants’ rate of salivary habituation to a taste stimulus is delayed compared
to normal-weight controls. This provides support that satiation in bariatric surgery candidates is impaired, possibly leading
to increased energy intake and positive energy balance. 相似文献
6.
Shohei Takeda Yutaka Inada Yoshiki Ozawa Narue Nakamizo Teruaki Tomaru 《Journal of anesthesia》1995,9(2):176-181
The cardiovascular responses to an infusion of KRN2391, a potassium channel opener, was studied in halothane-anesthetized
dogs. Intravenous administration of KRN2391 at 1.0 and 5.0 μg·kg−1·min−1 for 60 min produced dose-dependent decreases in mean arterial pressure (MAP) and systemic vascular resistance (SVR) associated
with dose-dependent increases in the cardiac index (CI) and stroke volume index (SVI) but was not accompanied by an increase
in heart rate (HR). The maximum decrease in MAP during the infusion of KRN2391 at 1.0 and 5.0 μg·kg−1·min−1 was −13±7% (P<0.01) and −37±10% (P<0.01), respectively. The maximum reduction in SVR after 1.0 and 5.0 μg·kg−1·min−1 was −20±11% (P<0.01) and −60±16% (P<0.01), respectively. A KRN2391 infusion of 1.0 and 5.0 μg·kg−1·min−1 increased Cl a maximum of 11±13% (P<0.05) and 65±33% (P<0.01), respectively. KRN2391 1.0 μg·kg−1·min−1 showed a tendency to increase SVI but this change was not significant, KRN2391 5.0 μg·kg−1·min−1, however, produced a significant increase in SVI. The present results demonstrate that the decrease in MAP and the increases
in CI and SVI caused by KRN2391 are due to a reduction in the afterload. Therefore, we conclude that these cardiovascular
profiles of KRN2391 may be benificial in perioperative uses including the control of systemic blood pressure and the treatment
of hypertension during halothane anesthesia in clinical practice. 相似文献
7.
Background: The increased pulmonary blood volume associated with the increased total blood volume in morbidly obese patients
increases pulmonary artery pressure and pulmonary vascular resistance, resulting in increased right ventricular (RV) afterload.
Thus, the morbidly obese may develop RV dysfunction owing to the increased RV afterload. We examined this possibility by assessing
RV contractile function in morbidly obese patients, using RV end-systolic pressure-volume relationship and RV systolic time
intervals. Methods: Included were 25 morbidly obese patients undergoing gastric bypass surgery under general anesthesia. Pulmonary
artery pressure and RV end-systolic volume were measured with a thermodilution pulmonary artery catheter. Pulmonary arterial
dicrotic notch pressure was used as an estimate of RV end-systolic pressure. Two data points were used to define RV end-systolic
pressure-volume relationship. RV systolic time intervals were determined by simultaneous graphic display of the electrocardiograph,
phonocardiograph, and pulmonary artery pressure curve, and were expressed as a pre-ejection period/RV ejection time ratio.
Results: The mean slope of right ventricular end-systolic pressure-volume relationship line was 0.54 ± 0.13 and mean pulmonary
vascular resistance 274 ± 80 dyne·sec·cm−5·m−2. The mean pre-ejection period/RV ejection time ratio was 0.4 ± 0.11. There was an inverse correlation between the pre-ejection/RV
ejection time ratio and the slope of RV end-systolic pressure-volume relationship line (R2=0.658, P<0.0001). Conclusion: Our data indicate that RV function is not depressed in morbid obesity despite increased RV afterload. 相似文献
8.
Background The study presents red blood cell (RBC) aggregability and deformability among obese patients qualified for bariatric surgery
and its correlation with plasma lipid concentration.
Methods We studied 40 morbidly obese patients who were qualified for bariatric surgery: mean age was 43.5 ± 11.3 years, and mean body
mass index (BMI) was 48.9 ± 7.7 kg/m2.The RBC deformability and aggregation parameters: aggregation index (AI), syllectogram amplitude (AMP) and aggregation half-time
(t1/2) were measured by Laser-assisted Optical Rotational Cell Analyser - LORCA.
Results Elongation index of RBC was significantly lower in obese patients than in the control group (P < 0.001) in 3.16–60.03 Pa shear stresses. Correlations between elongation index and triglyceride levels ranged between 0.42
to 0.44 (P < 0.05). AI was significantly higher in the obese patients (P < 0.001), t1/2 and the AMP were decreased (P < 0.001) compared to the control group. The RBC aggregation index correlated positively with total cholesterol level (r =
0.61, P < 0.05), non-HDL cholesterol level (r = 0.54, P < 0.05) and BMI (r = 0.48, P < 0.05). Negative correlation presented t1/2 with total cholesterol (r = −0.64, P < 0.05), non-HDL cholesterol (r = −0.51, P < 0.05) and BMI (r= −0.59, P < 0.05).
Conclusion Obesity is associated with RBC rheological disturbances expressed by a decrease in RBC deformability, increased total aggregation
extent and the alteration of kinetics of RBC aggregation. These results may suggest the necessity of introducing treatment
forms to correct erythrocyte rheological properties, which may improve the blood-flow condition in the microcirculation and
prevent postoperative complications after bariatric surgery. 相似文献
9.
Background: Laparoscopic adjustable gastric banding (LAGB) is commonly indicated in morbidly obese patients. There is controversy regarding
the hemodynamic effects of pneumoperitoneum (PNP) in obese patients. PNP and changes in body posture have complex effects
on venous return that may be detected by respiratory changes in the arterial pressure waveform. The aim of this study was
to compare pneumoperitoneum-induced and reverse Trendelenburg (RT) changes in arterial pulse pressure in obese and normal-weight
patients. Methods: 15 morbidly obese patients undergoing LAGB were compared to 15 normal-weight patients undergoing laparoscopic surgery. Arterial
pressure was non-invasively recorded using an arterial tonometer. Respiratory changes in pulse pressure (ΔPp) were recorded
in the supine position without and with PNP, and in RT position with pneumoperitoneum. Results: PNP increased ΔPp values in normal weight (P<0.001), but not in obese patients. RT position increased ΔPp values in obese patients, but did not cause additional changes
in normal-weight patients. Conclusions: Unlike normal-weight patients, PNP in the supine position has minimal effect on the arterial pulse-pressure wave-form in
obese patients. This observation may reflect physiological differences in total blood volume and loading conditions of the
heart between morbidly obese and normal-weight patients, which affect venous return during PNP. Differences in abdominal vascular
zone conditions between obese and normal weight-patients may explain these results. 相似文献
10.
Background: Obese patients are at increased risk for biliary disease. The prevalence and type of gallbladder pathology in
morbidly obese patients was evaluated, and compared with a non-obese control group. Methods: A consecutive series of obese
patients (n=478) who had undergone bariatric surgery with concurrent routine cholecystectomy and a consecutive group of organ
donors (n=481) were compared. Gallbladder pathology was defined as: cholelithiasis, cholecystitis, cholesterolosis, or normal
pathology. Results: Mean age of obese patients and of donors was 42 ± 9 and 43 ± 17 years respectively and mean BMI was 52
± 10 and 27 ± 7 kg/m2 respectively, P<0.05. There were more females in the obesity group (88% vs 47%, P<0.0001). 31% of obese patients and 7% of controls had a previous cholecystectomy (P<0.0001). 21% of the obese and 72% of the controls had normal gallbladder pathology (P<0.0001). Overall, obese patients had a higher incidence of cholelithiasis (25% vs 5%, P<0.0001), cholecystitis (50% vs 17%, P<0.0001), and cholesterolosis (38% vs 6%, P<0.0001) compared with controls. Obese patients with BMI <50 were more likely than those with BMI ≥50 to have normal gallbladder
pathology (27% vs 14%, P<0.001). Female patients were more likely to have undergone previous cholecystectomy than males in both the obese group (34%
vs 11%, P<0.001) and the control group (12% vs 2%, P<0.0001). Normal pathology was more common in male patients (80% vs 63%, P<0.0001) and patients <50 years (76% vs 66%, P<0.05) in the control group. Conclusions: Obese patients have an increased incidence of benign gallbladder disease than a
group of controls, and the relative risk appears to be positively correlated with the level of increase in the BMI. Obesity
appears to change the effect of age and gender on gallbladder pathology. 相似文献
11.
Santiago-Recuerda A Gómez-Terreros FJ Caballero P Martin-Duce A Soleto MJ Vesperinas G Pérez-Fernández E Villamor J Alvarez-Sala R 《Obesity surgery》2007,17(5):689-697
Background The authors studied changes in the upper airway in morbidly obese women and the relationship to sleep apnea-hypopnea syndrome
(OSAS).
Methods Patients underwent a cardiorespiratory polygraphic study, respiratory function test (spirometry, plethysmography, maximum
inspiratory pressures and arterial blood gas analysis), and computed tomographic studies of the upper airway.
Results 40 morbidly obese women being evaluated for bariatric surgery (mean age 39.6 ± 9.6 years old, BMI 48.7 ± 5.6 kg/m2) were studied. 37 women had OSAS, and 14 had severe OSAS. Results on respiratory function tests were normal. BMI and weight
had a positive correlation with apnea-hypopnea index (AHI), apnea index (AI), desaturation index (DI), lowest oxygen saturation
and CT90. Uvula diameter had a negative correlation with FEV1, FVC, VC IN and a positive correlation with TLC. Retropharynx soft tissue at the retropalatal level had a negative correlation
with FEV1, FVC and VC IN. The oropharynx area at maximal inspiration (total lung capacity) obtained a negative correlation with the
AHI (r = −0.423, P = 0.044), AI (r = −0.484, P = 0.042) and DI (r = −0.484, P = 0.019).
Conclusions Prevalence of OSAS in morbidly obese women is very high. Our results show the significant correlation between BMI and AHI
in morbidly obese women. Uvula diameter and retropharynx soft tissue are the upper airway parameters with higher relationship
with pulmonary function. A reduction in the cross-sectional area of the airway at the level of the oropharynx could be related
to the severity of OSAS in morbidly obese women. 相似文献
12.
Increased Serum Amyloid A Concentrations in Morbid Obesity Decrease after Gastric Bypass 总被引:2,自引:2,他引:0
Gómez-Ambrosi J Salvador J Rotellar F Silva C Catalán V Rodríguez A Jesús Gil M Frühbeck G 《Obesity surgery》2006,16(3):262-269
Background: Obesity is considered a state of low-grade chronic inflammation, which may favor the development of cardiovascular
diseases. Serum amyloid A (SAA) is an acute phase protein synthesized in response to infection, inflammation, injury, and stress. The aim of the present
study was to compare the circulating concentrations of SAA and the mRNA expression in omental adipose tissue between lean
and obese individuals and to analyze the effect of weight loss after gastric bypass. Methods: 16 lean volunteers (BMI 20.5
± 0.6 kg/m2) and 24 obese patients (BMI 47.0 ± 1.2 kg/m2) were included in the study. Serum concentrations of SAA were measured by ELISA. In addition, the concentrations of SAA in
18 morbidly obese patients (7 male/11 female; BMI 44.6 ± 1.9 kg/m2) were measured before and after weight loss following Roux-en-Y gastric bypass (RYGBP). SAA expression in omental adipose
tissue was quantified by RT-PCR in biopsies from obese patients undergoing RYGBP and from age-matched lean individuals subjected
to Nissen fundoplication. Results: Obese patients exhibited significantly increased circulating SAA concentrations (6.6 ±
0.5 vs 39.3 ± 9.1 μg/ml; P<0.01) compared to lean subjects. A significant positive correlation was found between logSAA and body fat (r=0.631, P<0.0001). Obese patients showed significantly increased (P<0.05) mRNA expression of SAA in omental adipose tissue compared to lean subjects. Weight loss significantly decreased SAA
concentrations after RYGBP (final BMI 28.5 ± 0.9 kg/m2, P<0.0001 vs initial) from 47.5 ± 14.5 to 15.7 ± 2.9 μg/ml (P<0.05). Conclusion: It can be concluded that serum SAA and mRNA expression of SAA in omental adipose tissue are increased
in obese patients contributing to the obesity-associated cardiovascular disease risk. Moreover, weight loss reduces SAA concentrations,
which may contribute to the beneficial effects accompanying weight reduction. 相似文献
13.
Coupaye M Bouillot JL Coussieu C Guy-Grand B Basdevant A Oppert JM 《Obesity surgery》2005,15(6):827-833
Background: Weight loss is associated with a decrease in both energy expenditure and circulating leptin levels. Whether this
holds true when the influence of body composition on energy expenditure and leptin is taken into account remains controversial.
The aim of the study was to assess changes in resting metabolic rate (RMR) and serum leptin adjusted for body composition
during surgically induced weight loss. Methods: In 36 women (age 42.7±8.7 years; BMI 47.2±8.5 kg/m2; mean±SD) undergoing laparoscopic adjustable gastric banding (LAGB) for morbid obesity, we measured RMR (by indirect calorimetry),
body composition (by dual-energy X-ray absorptiometry) and serum leptin (by immunoradiometry), immediately before and 1 year
after surgery. Results: 1 year after LAGB, there were significant decreases in body weight (−23.7±11.6 kg, P<0.001), fat mass (FM: −20.9±11.3 kg, P<0.0001), lean body mass (LBM: −3±5.3 kg, P=0.005), RMR (−298±309 kcal/day, P<0.0001), serum leptin (−24.0±18.4 ng/ml, P<0.0001), RMR/LBM ratio (−3.9±5.8 kcal/kg LBM/day, P<0.01) and leptin/FM ratio (−0.21±0.29 ng/kg FM/ml, P<0.001). RMR values after surgery were correctly predicted by the regression equation relating RMR to LBM and FM at baseline,
whereas this was not the case for serum leptin (in relation to FM). Conclusions: Changes in RMR 1 year after LAGB were explained
by changes in body composition whereas changes in serum leptin were not. The data provide no evidence for a metabolic adaptation
of RMR with weight loss, but suggest that serum leptin is decreased beyond expected values based on body composition, a factor
that may favor weight regain after surgically induced weight loss. 相似文献
14.
Cardoso-Júnior A Coelho LG Savassi-Rocha PR Vignolo MC Abrantes MM de Almeida AM Dias EE Vieira Júnior G de Castro MM Lemos YV 《Obesity surgery》2007,17(2):236-241
Background It has been suggested that obesity is associated with an altered rate of gastric emptying. The objective of the present study
was to determine whether the rates of solid and semi-solid gastric emptying differ between morbidly obese patients and lean
subjects.
Methods The Gastric-emptying time (GET) of solid and semi-solid meals were compared between lean healthy subjects and morbidly obese
patients enrolled in two previously published studies. GET of solid and semi-solid meals was measured using the 13C-octanoic acid breath test and 13C-acetic acid breath test, respectively, in 24 lean and 14 morbidly obese individuals of both sexes. Student t-test was used to compare the mean data between the lean and morbidly obese groups. The influence of sex, gender, BMI and
morbid obesity on the GET of solid meals was verified by linear regression analysis.
Results Mean t(1/2) values of solid GET (± standard deviation) were 203.6 ± 76.0 min and 143.5 ± 19.1 min for lean and obese subjects,
respectively (P = 0.0010). Mean t(lag) values of solid GET were 127.3 ± 42.7 min and 98.4 ± 13.0 min for lean and obese subjects, respectively
(P = 0.0044). No significant difference in semi-solid GET was observed between the lean and morbidly obese groups.
Conclusion The present study demonstrated a significantly enhanced gastric emptying of the solid meal test in morbidly obese patients
when compared to lean subjects. This finding is compatible with the hypothesis that rapid gastric emptying in morbidly obese
subjects increases caloric intake due to a more rapid loss of satiety. 相似文献
15.
Mohamed R. El-Tahan Osama M. Warda Douaa G. Diab Eyad A. Ramzy Mohamed K. Matter 《Journal of anesthesia》2009,23(2):215-221
Purpose Intravenous infusion of lidocaine attenuates the stress response to surgery. We aimed to evaluate the effects of perioperative
lidocaine on the hemodynamic and hormonal responses for cesarean delivery.
Methods After the gaining of ethical approval, 90 patients scheduled for elective cesarean delivery were randomly allocated to receive
either lidocaine 1.5 mg·kg−1 i.v. bolus 30 min before induction, followed by an infusion of 1.5 mg·kg−1·h−1 until 1 h after surgery (n = 45), or saline placebo (n = 45). Anesthesia was maintained with 50% nitrous oxide in oxygen with 0.7% isoflurane. Hemodynamic variables, plasma cortisol,
maternal and neonatal lidocaine concentrations, Apgar scores at 1 and 5 min, neonatal acid-base status, and the neurologic
and adaptive capacity score (NACS) were recorded.
Results After induction, patients receiving lidocaine had a smaller increase in heart rate and mean arterial blood pressure (P < 0.02) and lower plasma cortisol concentrations (31.1 ± 9.91 vs 45.6 ± 8.43 μg·dL−1; P < 0.001). There were no differences between the two groups in Apgar scores, NACS, or neonatal acid-base status. After delivery,
maternal and umbilical venous concentrations and umbilical vein-to-maternal vein ratios of lidocaine were 2.05 ± 0.42 μg·mL− and 1.06 ± 0.31 μg·mL−1, and 0.52 ± 0.07, respectively.
Conclusion Perioperative lidocaine is safe and effective in attenuating the maternal stress response to surgery for cesarean delivery. 相似文献
16.
Gastro-Esophageal Reflux and Esophageal Motility Disorders in Morbidly Obese Patients before and after Bariatric Surgery 总被引:6,自引:6,他引:0
Merrouche M Sabaté JM Jouet P Harnois F Scaringi S Coffin B Msika S 《Obesity surgery》2007,17(7):894-900
Background Obesity is a predisposing factor to gastro- esophageal reflux disease (GERD), but esophageal function remains poorly studied
in morbidly obese patients and could be modified by bariatric surgery.
Methods Every morbidly obese patient (BMI ≥40 kg/m2 or ≥35 in association with co-morbidity) was prospectively included with an evaluation of GERD symptoms, endoscopy, 24-hour
pH monitoring and esophageal manometry before and after adjustable gastric banding (AGB) or Roux-en-Y gastric bypass (RYGBP).
Results Before surgery, 100 patients were included (84 F, age 38.4 ± 10.9 years, BMI 45.1 ± 6.02 kg/m2), of whom 73% reported GERD
symptoms. Endoscopy evidenced hiatus hernia in 39.4% and esophagitis in 6.4%. The DeMeester score was pathological in 53.3%;
69% of patients had lower esophageal sphincter (LES) pressure <15 mmHg and 7 had esophageal dyskinesia. BMI was significantly
related to the DeMeester score (P = 0.018) but not to LES tone or esophageal dyskinesia. Postoperative data were available in 27 patients (AGB n = 12/60, RYGBP
n = 15/36). The DeMeester score (normal <14.72) was significantly decreased after RYGBP (24.8 ± 13.7 before vs 5.8 ± 4.9 after;
P < 0.001) but tended to increase after AGB (11.5 ± 5.1 before vs 51.7 ± 70.7 after; P = 0.09), with severe dyskinesia in 2 cases. Conclusion: GERD and LES incompetence are highly prevalent in morbidly obese
patients. Preliminary postoperative data show different effects of RYGBP and AGB on esophageal function, with worsening of
pH-metric data with occasional severe dyskinesia after AGB. 相似文献
17.
18.
Net Fluxes Over Working Thigh of Hormones,Growth Factors and Biomarkers of Bone Metabolism During Short Lasting Dynamic Exercise 总被引:8,自引:0,他引:8
The purpose of this study was to evaluate the responses of hormones, growth factors, and biomarkers involved in bone and
muscle metabolism during exercise and in recovery. One leg knee-extension exercise and concomitant sampling from the artery
and vein were performed. In 12 healthy individuals (6 men and 6 women; age 21–36 years) blood was drawn from the femoral artery
and vein at rest, after 10 minutes warm-up, after 15 minutes work at 61% of peak one leg VO2, and after 5 minutes work at peak one leg VO2, as well as 5, 30, and 60 minutes in recovery. Blood flow in the femoral vein was measured using the thermodilution technique.
Arteriovenous differences were measured over working thigh for growth hormone (GH), insulin-like growth factor I (IGF-I),
insulin-like growth factor binding protein 3 (IGF BP3), parathyroid hormone (PTH) and bone biomarkers, i.e., the carboxyterminal
propeptide of type I procollagen (PICP), the carboxyterminal cross-linked telopeptide of type I collagen (ICTP), osteocalcin,
and bone-specific alkaline phosphatase (b-ALP). There was an uptake of GH (3.1 ± 1.2 mU · min−1, P < 0.001; mean ± SE) over thigh during exercise and a release of IGF-I at the end of exercise (60 ± 36 μg · min−1; P < 0.01). PICP was also released after the maximal exercise (23 ± 12 μg · min−1; P < 0.01) as well as ICTP (0.5 ± 0.3 μg · min−1; P < 0.05) and b-ALP (0.2 ± 0.1 μkat · min−1; P < 0.05). Osteocalcin, IGF BP3, and PTH revealed no clearcut pattern. In the present study, exercise induces endocrine changes
which point to anabolic effects on muscle and bone tissue.
Received: 12 February 1996 / Accepted: 6 June 1996 相似文献
19.
Kuniyoshi T Kakihana Y Isowaki S Nagata E Tobo K Kaminosono T Hashiguchi T Tahara M Kawamae H Okayama N Kanmura Y 《Journal of anesthesia》2005,19(4):295-301
Purpose This study was performed in order to assess the effects of olprinone, a phosphodiesterase III inhibitor, on hepatic oxygen
delivery (DO2H), oxygen consumption (VO2H), and mitochondrial oxidation in the liver of a porcine endotoxemia model.
Methods Fourteen pigs received continuous infusion of endotoxin via the portal vein for 240 min. From t = 150 to t = 240 min, animals
were randomly divided into two groups to receive saline (control [CONT]; n = 7), or olprinone (OLP; n = 7) via the central vein.
Results In the OLP group, prior to olprinone treatment at 150 min, endotoxin induced significant decreases in the cardiac index (CI;
from 120 ± 31 to 65 ± 13 ml·kg−1·min−1; P < 0.01) and DO2H (from 3.58 ± 0.81 to 1.55 ± 0.49 ml·kg−1·min−1; P < 0.01), while VO2H was maintained. After administration of olprinone (from t = 150 to t = 240 min), CI was unchanged, while DO2H increased from 1.55 ± 0.49 to 1.93 ± 0.38 ml·kg−1·min−1 (P < 0.01) and VO2H increased from 0.42 ± 0.28 to 0.69 ± 0.38 ml·kg−1·min−1 (P < 0.01). At t = 240 min, the oxidation level of cytochrome aa3 was significantly higher in the OLP group than in the CONT
group (OLP, 66.2 ± 19.3% vs CONT, 26.4 ± 17.3%; P < 0.01).
Conclusion Our data for this porcine endotoxemia model suggest that olprinone may have beneficial therapeutic effects in restoring not
only systemic and hepatic circulation but also mitochondrial oxidation in the liver. 相似文献
20.
György S. Reusz Mariann Dobos Barna Vásárhelyi Péter Sallay András Szabó Csaba Horváth Antal Szabó Dennis J. Byrd Hubert H. Thole Tivadar Tulassay 《Pediatric nephrology (Berlin, Germany)》1998,12(1):30-34
Erythrocyte sodium-potassium (Na+/K+) -ATPase and sodium-lithium (Na+/Li+) countertransport activities were measured in 18 children (aged 9.6 years, range 6–16 years) with idiopathic hypercalciuria
(IHU) to evaluate cellular Na handling. The effect of chronic thiazide administration on these parameters and on bone mineral
density was also evaluated. Patients with IHU had significantly lower erythrocyte Na+/K+-ATPase activity than 23 age-matched healthy controls (mean±SEM 2,156±110 μmol P/l erythrocyte per hour vs. 3,165±175, P<0.01). Thiazide treatment significantly lowered urinary calcium excretion; this was followed by a slight suppression of
intact parathyroid hormone (iPTH). The urinary calcium/creatinine ratio before and during treatment was 0.90±0.07 mmol/mmol versus 0.51±0.06 respectively, P<0.01. The corresponding iPTH levels were 5.9±0.6 pmol/l and 5.1±0.7, P<0.05. The Na
+
/K
+
-ATPase activity increased significantly (2,769±169 μmol P/l erythrocyte per hour vs. 2,156±110 in the control period, P<0.01) and the Na
+
/Li
+
countertransport decreased (268±28 μmol Li/l erythrocyte per hour vs. 328
+
26 in the control period, P<0.03). The bone mineral density Z score rose from –1.3±0.26 to –0.8±0.22 (P<0.03). We conclude that IHU is accompanied by
abnormalities of erythrocyte Na
+
/K
+
-ATPase and Na
+
/Li
+
countertransport which are corrected by chronic hydrochlorothiazide administration. These changes could model alterations
in renal tubular transport mechanisms still to be elucidated. Chronic thiazide treatment also has a positive effect on bone
mineral density.
Received March 3, 1997; received in revised form and accepted July 7, 1997 相似文献