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1.
Background
Patients with metopic craniosynostosis and trigonocephaly are classically treated with a fronto-orbital advancement. In contrast, a minimally invasive treatment entails a narrow ostectomy of the fused suture, followed by postoperative helmet molding. The goal of this project was to investigate the results of patients treated with minimally invasive techniques by quantifying the deformity of the forehead contour a year after their operation and comparing these measurements to patients who underwent an open operation as a control.Methods
The 1-year postoperative computed tomography (CT) scans of patients treated with minimally invasive techniques for metopic craniosynostosis (n?=?10) were compared to CT scans of patients treated with an open operation (n?=?20). The straight line measurements between the zygomaticofrontal (ZF) sutures and between the dacryon bilaterally were recorded to assess the degree of hypotelorism. An axial plane two-dimensional angle between frontotemporale bilaterally and the glabella (FTR-G-FTL) was used as a measurement of the severity of trigonocephaly.Results
The average age of patients at surgery for minimally invasive cases was 3.4?±?0.5 months old (mean ± standard error of the mean) compared with the age of patients for open cases at 11.3?±?0.6 months old. Seventy percent of the patients were males and 30 % were females in both the minimally invasive and open groups. The mean distance between the ZF sutures was 76.3?±?1.9 mm in the minimally invasive group and 75.9?±?1.2 mm in the open group (p?=?0.90). The mean distance between the dacryon bilaterally was 15.1?±?1.0 mm in the minimally invasive group and 14.5?±?0.6 mm in the open group (p?=?0.63). The FTR-G-FTL angle was 118.5°?±?13.2° in the minimally invasive group and 113.1°?±?2.0° in the open group (p?=?0.21).Conclusions
In this small, retrospective series, minimally invasive treatment of metopic craniosynostosis appears to have equivalent results to open fronto-orbital advancement in terms of the acuity of trigonocephalic forehead angle and hypotelorism at 1-year follow-up. Additional studies are being conducted to better quantify, validate, and compare these measurements. The end goal is to elucidate the best methods of quantifying normal forehead contours and to determine if minimally invasive treatment is equivalent to the open approach. Level of Evidence: Level IV, therapeutic study. 相似文献2.
Andreas Klinger Michael Buchfelder Sven Martin Schlaffer Natalia Kremenevskaja Andrea Kleindienst 《Acta neurochirurgica》2013,155(11):2177-2182
Background
One of the major concerns in transsphenoidal surgery are infections because the approach to the pituitary includes a route of microbial colonization. To minimize the associated morbidity and mortality, a surveillance program is crucial to monitor for perioperative infections.Methods
For 1 year, we analysed body temperature (BT), erythrocyte sedimentation rate (ESR), white blood cell count (WBC), C-reactive protein (CRP), interleukin 6 (IL-6) and lipopolysaccharide-binding-protein (LBP) following elective transsphenoidal pituitary surgery. Samples were collected on admission, day 1, 3 and 7 as well as 3 months postoperatively.Results
In 116 patients, all data were available. No postoperative infections occurred within the first postoperative week. BT (37.6?±?0.6, baseline 37.0?±?0.5 °C), WBC (11,366?±?2,541, baseline 6,861?±?2,123/μl), CRP (25.3?±?22.6, baseline 3.1?±?6 mg/l), IL-6 (12?±?13, baseline 2.7?±?2.6 pg/ml), and LBP (11.3?±?4.9, baseline 5.7?±?2.7 μg/ml) peaked on day 1 postoperatively (each p?=?0.001), while ESR peaked on day 3 (25?±?16, baseline 13?±?11 mm/h, p?=?0.001). BT and IL-6 normalized by day 3 and CRP by day 7, while ESR (23?±?16 mm/h, p?=?0.001), WBC (7,807?±?2,750/μl, p?=?0.001) and LBP (7.3?±?2.6 μg/ml, p?=?0.028) were still increased by day 7.Conclusion
The present study establishes normative values for an infection surveillance following transsphenoidal pituitary surgery. CRP, a convenient and reasonable priced parameter, is affected by the procedure for the first postoperative week. IL-6 is more robust and allows a close monitoring on the expense of additional pricing. ESR, WBC and LBP are sustained affected by surgery, and do not offer any advantage. Since no infections were observed, we were unable to calculate the respective sensitivity and specificity. 相似文献3.
Vilma Dzenkeviciūte Zaneta Petrulioniene Virginijus Sapoka Sigita Aidietiene Lina Abaraviciute 《Obesity surgery》2014,24(11):1961-1968
Background
Herein, we investigate the anthropometric, biochemical and left ventricle (LV) geometry changes following the laparoscopic adjustable gastric banding (LAGB) operation in morbidly obese individuals.Methods
Eighty-three morbidly obese participants (mean age, 46.1?±?11.5 years; 30.1 % men), scheduled for elective LAGB were examined before and 12 months after the surgery. LV geometry and diastolic function were investigated by 2-dimensional echocardiography, whereas laboratory tests assessed the glycaemic, serum lipid and inflammatory marker profiles.Results
Twelve months after the operation, body mass index (BMI) decreased from 46.9?±?7.2 kg/m2 to 40.1?±?8.2 kg/m2 (p?0.05), which was associated with the significant improvements in glycaemic control, inflammatory state, LV end-diastolic diameter (53.6?±?4.6 mm vs. 52.9?±?4.1 mm, p?0.05), LV mass (223.6?±?61.3 vs. 215.4?±?52.7 g, p?0.05) and LV mass index (53.9?±?14.1 g/m2.7 vs. 52.0?±?12.3 g/m2.7, p?0.05). However, no overall improvements in LV geometry or the prevalence of LV hypertrophy subtypes were recorded 12 months after the LAGB. The reduction in LV end-diastolic diameter (ß?=?0.56, p?=?0.0001) and BMI (ß?=?0.26, p?=?0.015) were both associated with diminished LV mass. Additionally, a statistically significant correlation between LV mass and changes in BMI (R?=?0.29, p?=?0.007), waist circumference (R?=?0.32, p?=?0.004), LV end-diastolic diameter (R?=?0.63, p?=?0.0001) and E-wave deceleration time (R?=??0.24, p?=?0.03) were observed within our study population.Conclusions
LV mass decreases 12 months after LAGB surgery, but no improvements in LV geometry and function occur. The regression of LV mass is better predicted by weight loss than by reduction in blood pressure or changes in metabolic parameters. 相似文献4.
J.-H. Park K.-C. Kang D.-E. Shin Y.-G. Koh J.-S. Son B.-H. Kim 《Osteoporosis international》2014,25(2):613-618
Summary
The progression of fractured vertebral collapse is not rare after a conservative treatment of vertebral compression fracture (VCF). Teriparatide has been shown to directly stimulate bone formation and improve bone density, but there is a lack of evidence regarding its use in fracture management. Conservative treatment with short-term teriparatide is effective for decreasing the progression of fractured vertebral body collapse.Introduction
Few studies have reported on the prevention of collapsed vertebral body progression after osteoporotic VCF. Teriparatide rapidly enhances bone formation and increases bone strength. This study evaluated preventive effects of short-term teriparatide on the progression of vertebral body collapse after osteoporotic VCF.Methods
Radiographs of 68 women with single-level osteoporotic VCF at thoracolumbar junction (T11–L2) were reviewed. Among them, 32 patients were treated conservatively with teriparatide (minimum 3 months) (group I), and 36 were treated with antiresorptive (group II). We measured kyphosis and wedge angle of the fractured vertebral body, and ratios of anterior, middle, and posterior heights of the collapsed body to posterior height of a normal upper vertebra were determined. The degree of collapse progression was compared between two groups.Results
The progression of fractured vertebral body collapse was shown in both groups, but the degree of progression was significantly lower in group I than in group II. At the last follow-up, mean increments of kyphosis and wedge angle were significantly lower in group I (4.0°?±?4.2° and 3.6°?±?3.6°) than in group II (6.8°?±?4.1° and 5.8°?±?3.5°) (p?=?0.032 and p?=?0.037). Decrement percentages of anterior and middle border height were significantly lower in group I (9.6?±?10.3 and 7.4?±?7.5 %) than in group II (18.1?±?9.7 and 13.8?±?12.2 %) (p?=?0.001 and p?=?0.025), but not in posterior height (p?=?0.086).Conclusions
In female patients with single-level osteoporotic VCF at the thoracolumbar junction, short-term teriparatide treatment did not prevent but did decrease the progression of fractured vertebral body collapse. 相似文献5.
Jiajia Luo Cornelia Betschart Luyun Chen James A. Ashton-Miller John O. L. DeLancey 《International urogynecology journal》2014,25(2):197-203
Introduction and hypothesis
A method was developed using 3D stress magnetic resonance imaging (MRI) and was piloted to test hypotheses concerning changes in apical ligament lengths and lines of action from rest to maximal Valsalva.Methods
Ten women with (cases) and ten without (controls) pelvic organ prolapse (POP) were selected from an ongoing case–control study. Supine, multiplanar stress MRI was performed at rest and at maximal Valsalva and was imported into 3D Slicer v. 3.4.1 and aligned. The 3D reconstructions of the uterus and vagina, cardinal ligament (CL), deep uterosacral ligament (USLd), and pelvic bones were created. Ligament length and orientation were then measured.Results
Adequate ligament representations were possible in all 20 study participants. When cases were compared with controls, the curve length of the CL at rest was 71 ±16 mm vs. 59?±?9 mm (p?=?0.051), and the USLd was 38?±?16 mm vs. 36?±?11 mm (p?=?0.797). Similarly, the increase in CL length from rest to strain was 30?±?16 mm vs. 15?±?9 mm (p?=?0.033), and USLd was 15?±?12 mm vs. 7?±?4 mm (p?=?0.094). Likewise, the change in USLd angle was significantly different from CL (p?<?0.001).Conclusions
This technique allows quantification of 3D geometry at rest and at strain. In our pilot sample, at maximal Valsalva, CL elongation was greater in cases than controls, whereas USLd was not; CL also exhibited greater changes in ligament length, and USLd exhibited greater changes in ligament inclination angle. 相似文献6.
Constantinos Nastos Konstantinos Kalimeris Nikolaos Papoutsidakis George Defterevos Agathi Pafiti Helen Kalogeropoulou Loukia Zerva Tzortzis Nomikos Georgia Kostopanagiotou Vasillios Smyrniotis Nikolaos Arkadopoulos 《Journal of gastrointestinal surgery》2011,15(5):809-817
Background
This study aims to evaluate whether injury of gut mucosa in a porcine model of post-hepatectomy liver dysfunction can be prevented using antioxidant treatment with desferrioxamine.Methods
Post-hepatectomy liver failure was induced in pigs combining major (70%) liver resection and ischemia/reperfusion injury. An ischemic period of 150 minutes, was followed by reperfusion for 24 h. Animals were randomly divided into a control group (n?=?6) and a desferrioxamine group (DFX, n?=?6). DFX animals were treated with continuous IV infusion of desferrioxamine 100 mg/kg. Intestinal mucosal injury (IMI), bacterial and endotoxin translocation (BT) were evaluated in all animals. Intestinal mucosa was also evaluated for oxidative markers.Results
DFX animals had significantly lower IMI score (3.3?±?1.2 vs. 1.8?±?0.9, p?<?0.05), decreased BT in the portal circulation at 0 and 12 h of reperfusion (p?=?0.007 and p?=?0.008, respectively), decreased portal endotoxin levels at 6 (p?=?0.006) and 24 h (p?=?0.004), decreased systemic endotoxin levels (p?=?0.01) at 24 h compared to controls. Also, 24 h post-reperfusion mucosal malondialdehyde and protein carbonyls were decreased in DFX animals compared to controls (4.1?±?1.2 vs. 2.5?±?1.2, p?=?0.05 and 0.5?±?0.1 vs. 0.4?±?0.1, p?=?0.04 respectively).Conclusion
Desferrioxamine seems to attenuate mucosal injury from post-hepatectomy liver dysfunction possibly through blockage of iron-catalyzed oxidative reactions. 相似文献7.
Edward L. Jones Thomas N. Robinson Jennifer R. McHenry Christina L. Dunn Paul N. Montero Henry R. Govekar Greg V. Stiegmann 《Surgical endoscopy》2012,26(11):3053-3057
Background
Electromagnetic coupling can occur between the monopolar “Bovie” instrument and other laparoscopic instruments without direct contact by a phenomenon termed antenna coupling. The purpose of this study was to determine if, and to what extent, radiofrequency energy couples to other common laparoscopic instruments and to describe practical steps that can minimize the magnitude of antenna coupling.Methods
In a laparoscopic simulator, monopolar radiofrequency energy was delivered to an L-hook. The tips of standard, nonelectrical laparoscopic instruments (either an unlit 10?mm telescope or a 5?mm grasper) were placed adjacent to bovine liver tissue and were never in contact with the active electrode. Thermal imaging quantified the change in tissue temperature nearest the tip of the telescope or grasper at the end of a 5?s activation of the active electrode.Results
A 5?s activation (30 watts, coagulation mode, 4?cm separation between instruments) increased tissue temperature compared with baseline adjacent to the grasper tip (2.2?±?2.2?°C; p?=?0.013) and telescope tip (38.2?±?8.0?°C; p?<?0.001). The laparoscopic telescope tip increased tissue temperature more than the laparoscopic grasper tip (p?<?0.001). Lowering the generator power from 30 to 15 Watts decreased the heat generated at the telescope tip (38.2?±?8.0 vs. 13.5?±?7.5?°C; p?<?0.001). Complete separation of the camera/light cords and the active electrode cord decreased the heat generated near the telescope tip compared with parallel bundling of the cords (38.2?±?8.0 vs. 15.7?±?11.6?°C; p?<?0.001).Conclusions
Commonly used laparoscopic instruments couple monopolar radiofrequency energy without direct contact with the active electrode, a phenomenon that results in heat transfer from a nonelectrically active instrument tip to adjacent tissue. Practical steps to minimize heat transfer resulting from antenna coupling include reducing the monopolar generator power setting and avoiding of parallel bundling of the telescope and active electrode cords. 相似文献8.
Casagrande DS Repetto G Mottin CC Shah J Pietrobon R Worni M Schaan BD 《Obesity surgery》2012,22(8):1287-1292
Background
Roux-en-Y gastric bypass (RYGB) surgery is the gold standard surgical treatment for obesity. However, unintended nutritional deficiencies following this surgery are common, including changes in bone metabolism. We assessed changes in bone mineral density (BMD), nutritional compounds, and bone resorption markers before and 1?year following RYGB surgery.Methods
Our study included 22 female patients with class II/III obesity. A clinical questionnaire, a 24-h recall, blood and urine samples, and dual-energy X-ray absorptiometry were provided.Results
Mean age was 37.2?±?9.6?years; 86?% were Caucasian and 77.2?% were premenopausal. Mean preoperative body mass index was 44.4?±?5.0 and 27.5?±?4.5?kg/m2 at 1-year follow-up (p?0.001). 25-OH-vitamin D-levels were similar in both periods [11.7 (9.7?C18.0) vs. 15.7 (10.2?C2.7) pg/dL, p?=?0.327]. Serum N-telopeptide (16.3?±?3.4 vs. 38.2?±?7.0 nM BCE, p?0.001) and parathyroid hormone (45.4?±?16.7 vs. 62.7?±?28.9?pg/mL, p?=?0.026) increased after RYGB surgery, reflecting bone resorption. BMD decreased after RYGB surgery in the lumbar spine (1.13?±?0.11 vs. 1.04?±?0.09?g/cm2, p?=?0.001), femoral neck (1.03?±?0.15 vs. 0.94?±?0.16?g/cm2, p?=?0.001), and total femur (1.07?±?0.11 vs. 0.97?±?0.15?g/cm2, p?=?0.003).Conclusions
Decreased BMD in the lumbar spine, femoral neck, and total femur is detectable in women 1?year after RYGB surgery. Calcium malabsorption, caused by vitamin D deficiency and increased bone resorption, is partially responsible for these outcomes and should be targeted in future clinical trials. 相似文献9.
CG Musso R Juarez M Vilas M Navarro H Rivera R Jauregui 《International urology and nephrology》2012,44(5):1559-1562
Introduction
It is known that chronic kidney disease (CKD) and senescence bring about a progressive reduction in glomerular filtration rate (GFR) and that in the former this is usually associated with an increase in the fractional excretion of calcium, phosphorus, magnesium, and uric acid. However, it has not yet been explained how these substances are excreted in the healthy oldest old. Thus, in the present study, we examined the renal handling of these substances in very aged people in comparison with CKD patients with similar GFR levels (stage III??CKD).Materials and methods
Twenty volunteers were studied; 10 of them were healthy very old (VO) (??75?years old) individuals and 10 were stage III CKD patients. Exclusion criteria were as follows: presence of altered (abnormally high or low) plasma calcium, phosphorus, magnesium and uric acid, as well as previous diagnoses of diabetes mellitus and obstructive uropathy and use of drugs that could alter plasma levels of the studied substances. All volunteers were on a diet with the same content of these elements (3-day dietary register). We measured calcium, phosphorus, magnesium, uric acid, creatinine in serum plasma and morning urine, as well as serum parathyroid hormone level, in each volunteer. From these data, fractional excretion (FE) of these substances was obtained. A statistical analysis was carried out using the Wilcoxon test.Results
Serum creatinine: 1.8?±?0.4?mg/dl (CKD) versus 0.8?±?0.2?mg/dl (VO), p?=?0.0002; serum calcium: 9.1?±?0.3?mg/dl (CKD) versus 8.7?±?0.4 (VO), p?=?0.022; serum magnesium: 2.3?±?0.2?mg/dl (CKD) versus 2.0?±?0.1 (VO), p?=?0.05; serum phosphorus: 3.9?±?0.5?mg/dl (CKD) versus 3.0?±?0.4?mg/dl (VO), p?=?0.002; serum uric acid: 6.6?±?1.5 (CKD) versus 5.2?±?1.4?mg/dl (VO), p?=?0.04; FE of calcium: 2.5?±?1?% (CKD) versus 0.8?±?0.3?% (VO), p?=?0.04; FE of magnesium: 7.2?±?4.1?% (CKD) versus 2.9?±?0.9?% (VO), p?=?0.02; FE of phosphorus: 25?±?9?% (CKD) versus 9.1?±?5.7(VO), p?=?0.001; FE of uric acid: 10?±?3?% (CKD) versus 8?±?5?% (VO), p?=?0.05.Conclusion
Serum levels and FE of calcium, phosphorus, magnesium and uric acid were significantly higher in CKD patients compared to healthy very old people with similar GFR, except for serum magnesium and FE of uric acid, which were similar in both groups. 相似文献10.
Beatriz Gras-Miralles Jenny Rosario Haya José Manuel Ramon Moros Albert Goday Arnó Sandra Torra Alsina Lucas Ilzarbe Sánchez Jordi Muñoz Galitó Inés-Ana Ibáñez Zafón M. Carmen Alonso Romera Alejandra Parri Bonet Felip Bory Ros Montserrat Andreu Garcia Sílvia Delgado-Aros 《Obesity surgery》2014,24(12):2138-2144
11.
Ana Ramos-Levi Andres Sanchez-Pernaute Pilar Matia Lucio Cabrerizo Ana Barabash Carmen Hernandez Alfonso Calle-Pascual Antonio Torres Miguel Rubio 《Obesity surgery》2013,23(10):1520-1526
Background
Controversy exists regarding type 2 diabetes (T2D) remission rates after bariatric surgery (BS) due to heterogeneity in its definition and patients' baseline features. We evaluate T2D remission using recent criteria, according to preoperative characteristics and insulin therapy (IT).Methods
We performed a retrospective study from a cohort of 657 BS from a single center (2006–2011), of which 141 (57.4 % women) had T2D. We evaluated anthropometric and glucose metabolism parameters before surgery and at 1-year follow-up. T2D remission was defined according to 2009 consensus criteria: HbA1c <6 %, fasting glucose (FG) <100 mg/dL, and absence of pharmacologic treatment. We analyzed diabetes remission according to previous treatment.Results
Preoperative characteristic were (mean?±?SD): age 53.9?±?9.8 years, BMI 43.7?±?5.6 kg/m2, T2D duration 7.4?±?7.6 years, FG 160.0?±?54.6 mg/dL, HbA1c 7.6?±?1.6 %. Fifty-six (39.7 %) individuals had IT. At 1-year follow-up, 74 patients (52.5 %) had diabetes remission. Percentage weight loss (%WL) and percentage excess weight loss (%EWL) were associated to remission (35.5?±?8.1 vs. 30.2?±?9.5 %, p?=?0.001; 73.6?±?18.4 vs. 66.3?±?22.8 %, p?=?0.037, respectively). Duration of diabetes, age, and female sex were associated to nonremission: 10.3?±?9.4 vs. 4.7?±?3.8 years, p?<?0.001; 55.1?±?9.3 vs. 51.2?±?9.9 years, p?=?0.017; 58.9 vs. 33.3 %, p?=?0.004, respectively. Prior treatment revealed differences in remission rates: 67.1 % in case of oral therapy (OT) vs. 30.4 % in IT, p?<?0.001. OR for T2D remission in patients with previous IT, compared to those with only OT, were 0.157–0.327 (p?<?0.05), adjusting by different models.Conclusions
Consensus criteria reveal lower T2D remission rates after BS than previously reported. Prior insulin use is a main setback for remission. 相似文献12.
Eva Pardina Roser Ferrer Juan Antonio Baena-Fustegueras Albert Lecube Jose Manuel Fort Víctor Vargas Roberto Catalán Julia Peinado-Onsurbe 《Obesity surgery》2010,20(5):623-632
Background
The relationship between C-reactive protein (CRP), nitric oxide (NO), leptin, adiponectin, and insulin growth factor 1 (IGF-1) is poorly defined in morbidly obese patients before and after gastric bypass and, in some cases, is controversial.Methods
We examined the plasma of 34 morbidly obese patients before and 1, 6, and 12 months after Roux-en-Y gastric bypass surgery.Results
Obese people had more CRP (21.3?±?1.8 μg/ml) and leptin (36.9?±?4.0 ng/ml) than those in the control group (nonobese people: CRP?= 6.9?±?0.9 μg/ml, p?<?0.0001; leptin?= 7.5?±?0.4 ng/ml, p?<?0.0001). However, they had less NO (30.4?±?2.7 nmol/ml), IGF-1 (77.5?±?6.6 ng/ml), and adiponectin (11.1?±?1.0 μg/ml) than those in the control group (NO?= 45.8?±?3.9 nmol/ml, p?=?0.0059; IGF-1?= 202.0?±?12.0 ng/ml, p?<?0.0001; adiponectin?= 18.0?±?2.0 μg/ml, p?<?0.0001). During weight loss, the amount of CRP and leptin decreased until they reached the nonobese values, but the level of NO remained lower than in nonobese people, even 1 year after surgery. The linear regression slopes were negative and very significant for leptin (p?=?0.0005) and CRP (p?=?0.0018) but were less significant for NO (p?=?0.0221). IGF-1 displayed a very good linear regression (both negative and significant) with some anthropometric parameters, including body mass index (p?=?0.0025), total fat (p?=?0.0177), and the percentage of fat (p?<?0.0001).Conclusion
For the first time, we report the relationship between IGF-1 and CRP, NO, leptin, and adiponectin. For all these parameters, the best and most widely demonstrated improvements in comorbidities before and during weight loss in morbid obesity were associated with CRP and leptin. 相似文献13.
Background
Hyperparathyroidism is much more common in women and therefore may represent different diseases in men and women. In order to understand the role of gender in hyperparathyroidism, we reviewed our experience.Methods
We analyzed a prospective database of 1309 consecutive patients with primary hyperparathyroidism who underwent parathyroidectomy at our institution between March 2001 and August 2010.Results
The female-to-male ratio was 3.3:1, and female patients were older at presentation (60?±?0 vs. 57?±?1?years, p?0.005). Male patients were more commonly asymptomatic at presentation (25?% vs. 18?%, p?=?0.005) and the most common symptom for men was kidney stones (23?% vs. 13?%, p?0.0001). For patients with bone density scans, osteoporosis was more common in women (34?% vs. 17?%, p?0.0001). Men had a slightly higher preoperative serum calcium level (11.1?±?0 vs. 11.0?±?0?mg/dl, p?=?0.03), higher parathyroid hormone level (140?±?7 vs. 124?±?4?pg/ml, p?=?0.04), higher urinary calcium level (376?±?10 vs. 314?±?5?mg/24?h, p?0.005), and lower vitamin D level (28?±?1 vs. 32?±?0?ng/ml, p?0.005). Men were more likely to have abnormally elevated creatinine values (15?% vs. 9?%, p?=?0.004). The operative approach as well as the number of glands involved and their location did not significantly differ between the groups. The mean gland weight for a single adenomas was higher in male patients (1123?±?128 vs. 636?±?32?mg, p?=?0.001). No significant difference was identified in the immediate and remote postoperative course.Conclusions
Hyperparathyroidism appears to present differently depending on gender. Male patients more often present without symptoms, present with vitamin D deficiency, and have larger parathyroid glands. Importantly, surgical outcomes were equivalent between men and women. 相似文献14.
Seyfried F Lannoo M Gsell W Tremoleda JL Bueter M Olbers T Jurowich C Germer CT le Roux CW 《Obesity surgery》2012,22(7):1117-1125
Background
A reproducible Roux-en-Y gastric bypass (RYGB) model in mice is needed to study the physiological alterations after surgery.Methods
Male C57BL6 mice weighing 29.0?±?0.8?g underwent either RYGB (n?=?14) or sham operations (n?=?6). RYGB surgery consisted of a small gastric pouch (~2?% of the initial stomach size), a biliopancreatic and alimentary limb of 10?cm each and a common channel of 15?cm. Animals had free access to standard chow in the postoperative period. Body mass and food intake were recorded for 60?days. Bomb calorimetry was used for faecal analysis. Anatomical rearrangement was assessed using planar X-ray fluoroscopy and computed tomography (CT) after oral Gastrografin? injection.Results
RYGB surgery led to a sustained reduction in body weight compared to sham-operated mice (postoperative week 1: sham 27.8?±?0.7?g vs. RYGB 26.5?±?1.0?g, p?=?0.008; postoperative week 8: sham 30.7?±?0.8?g vs. RYGB 28.4?±?1.1?g, p?=?0.003). RYGB mice ate less compared to shams (sham 4.6?±?0.2?g/day vs. RYGB 4.3?±?0.4?g/day, p?0.001). There were no differences in faecal mass (p?=?0.13) and faecal energy content (p?=?0.44) between RYGB and shams. CT scan demonstrated the expected anatomical rearrangement without leakage or stenosis. Fluoroscopy revealed rapid pouch emptying.Conclusions
RYGB with a small gastric pouch is technically feasible in mice. With this model in place, genetically manipulated mouse models could be used to study the physiological mechanisms involved with metabolic changes after gastric bypass. 相似文献15.
Patrick B. White Kathryn M. Ziegler Deborah A. Swartz-Basile Sue S. Wang Keith D. Lillemoe Henry A. Pitt Nicholas J. Zyromski 《Journal of gastrointestinal surgery》2012,16(9):1680-1685
Background
Obesity accelerates pancreatic cancer growth; the mechanisms underlying this association are poorly understood. This study evaluated the hypothesis that obesity, rather than high-fat diet, is responsible for accelerated pancreatic cancer growth.Methods
Male C57BL/6J mice were studied after 19?weeks of high-fat (60?% fat; n?=?20) or low-fat (10?% fat; n?=?10) diet and 5?weeks of Pan02 murine pancreatic cancer growth (flank).Results
By two-way ANOVA, diet did not (p?=?0.58), but body weight, significantly influenced tumor weight (p?=?0.01). Tumor weight correlated positively with body weight (R 2?=?0.562; p?<?0.001). Tumors in overweight mice were twice as large as those growing in lean mice (1.2?±?0.2?g vs. 0.6?±?.01?g, p?<?0.01), had significantly fewer apoptotic cells than those in lean mice (0.8?±?0.4 vs 2.4?±?0.5; p?<?0.05), and greater adipocyte volume (3.7 vs. 2.2?%, p?<?0.05). Apoptosis (R 2?=?0.472; p?=?0.008) and serum adiponectin correlated negatively with tumor weight (R?=?0.45; p?<?0.05).Conclusions
These data suggest that body weight, and not high-fat diet, is responsible for accelerated murine pancreatic cancer growth observed in this model of diet-induced obesity. Decreased tumor apoptosis appears to play an important mechanistic role in this process. The concept that decreased apoptosis is potentiated by hypoadiponectinemia (seen in obesity) deserves further investigation. 相似文献16.
V. Phan T. Blydt-Hansen J. Feber N. Alos S. Arora S. Atkinson L. Bell C. Clarson R. Couch E. A. Cummings G. Filler R. M. Grant J. Grimmer D. Hebert B. Lentle J. Ma M. Matzinger J. Midgley M. Pinsk C. Rodd N. Shenouda R. Stein D. Stephure S. Taback K. Williams F. Rauch K. Siminoski L. M. Ward 《Osteoporosis international》2014,25(2):627-637
Summary
Incident vertebral fractures and lumbar spine bone mineral density (BMD) were assessed in the 12 months following glucocorticoid initiation in 65 children with nephrotic syndrome. The incidence of vertebral fractures was low at 12 months (6 %) and most patients demonstrated recovery in BMD Z-scores by this time point.Introduction
Vertebral fracture (VF) incidence following glucocorticoid (GC) initiation has not been previously reported in pediatric nephrotic syndrome.Methods
VF was assessed on radiographs (Genant method); lumbar spine bone mineral density (LS BMD) was evaluated by dual-energy X-ray absorptiometry.Results
Sixty-five children were followed to 12 months post-GC initiation (median age, 5.4 years; range, 2.3–17.9). Three of 54 children with radiographs (6 %; 95 % confidence interval (CI), 2–15 %) had incident VF at 1 year. The mean LS BMD Z-score was below the healthy average at baseline (mean ± standard deviation (SD), ?0.5?±?1.1; p?=?0.001) and at 3 months (?0.6?±?1.1; p?<?0.001), but not at 6 months (?0.3?±?1.3; p?=?0.066) or 12 months (?0.3?±?1.2; p?=?0.066). Mixed effect modeling showed a significant increase in LS BMD Z-scores between 3 and 12 months (0.22 SD; 95 % CI, 0.08 to 0.36; p?=?0.003). A subgroup (N?=?16; 25 %) had LS BMD Z-scores that were ≤?1.0 at 12 months. In these children, each additional 1,000 mg/m2 of GC received in the first 3 months was associated with a decrease in LS BMD Z-score by 0.39 at 12 months (95 % CI, ?0.71 to ?0.07; p?=?0.017).Conclusions
The incidence of VF at 1 year was low and LS BMD Z-scores improved by 12 months in the majority. Twenty-five percent of children had LS BMD Z-scores ≤?1.0 at 12 months. In these children, LS BMD Z-scores were inversely associated with early GC exposure, despite similar GC exposure compared to the rest of the cohort. 相似文献17.
Candace Y. Parker-Autry Alayne D. Markland Alicia C. Ballard Deidra Downs-Gunn Holly E. Richter 《International urogynecology journal》2012,23(12):1699-1705
Introduction and hypothesis
Our aim was to characterize the relationship between 25-hydroxyvitamin D [25(OH)D] status with pelvic floor symptom distress and impact on quality of life.Methods
A retrospective chart review was performed in women with a 25(OH)D level drawn within 1 year of their gynecology/urogynecology visit. Validated questionnaires including the Colorectal?CAnal Distress Inventory (CRADI)-8 and Incontinence Impact Questionnaire (IIQ-7) were used. Multivariate analyses characterized pelvic floor disorder (PFD) symptom differences among women by vitamin D status.Results
We studied 394 women. Mean ± standard deviation (SD) 25(OH)D levels were higher in women without than with PFD symptoms (35.0?±?14.1 and 29.3?±?11.5 ng/ml, respectively (p?<?0.001)]. The prevalence of vitamin D insufficiency was 51% (136/268). CRADI-8 and IIQ-7 scores were higher among women with vitamin D insufficiency (p?=?0.03 and p?=?0.001, respectively). Higher IIQ-7 scores were independently associated with vitamin D insufficiency (p?<?0.001).Conclusions
Insufficient vitamin D is associated with increased colorectal symptom distress and greater impact of urinary incontinence on quality of life. 相似文献18.
Liying Zhao Yanan Wang Hao Liu Hao Chen Haijun Deng Jiang Yu Qi Xue Guoxin Li 《Journal of gastrointestinal surgery》2014,18(5):1003-1009
Background
The role of laparoscopic surgery for advanced transverse colon cancer (TCC) remains controversial, especially in terms of long-term oncologic outcomes.Methods
This retrospective cohort study enrolled 157 consecutive patients who underwent curable resections for advanced TCC between January 2002 and June 2011 (laparoscopic-assisted colectomy (LAC), n?=?74; open colectomy (OC), n?=?83). Short-term outcomes and oncologic long-term outcomes were compared between the two groups.Results
Compared to the OC group, patients in the LAC group had less blood loss (LAC vs. OC, 79.6?±?70.3 vs. 158.4?±?89.3 ml, p?<?0.001), faster return of bowel function (2.6?±?0.7 vs. 3.8?±?0.8 days, p?<?0.001), and shorter postoperative hospital stay (10.3?±?3.7 vs. 12.6?±?6.0 days, p?=?0.007). Conversions were required in four (5.4 %) patients. Rates of short-term complication, mortality, and long-term complication were comparable between the two groups. The median follow-up time was 54 (26–106) months in the LAC group and 58 (29–113) months in the OC group (p?=?0.407). There were no statistical differences in the rates of 5-year overall survival (73.6 vs. 71.1 %, p?=?0.397) and 5-year disease-free survival (70.5 vs. 66.7 %, p?=?0.501) between the two groups.Conclusions
Laparoscopic surgery for advanced TCC yield short-term benefits while achieving equivalent long-term oncologic outcomes. 相似文献19.
Rajeev Ramanah Julian Mairot Marie-Caroline Clement Bernard Parratte Robert Maillet Didier Riethmuller 《International urogynecology journal》2010,21(9):1151-1156
Introduction and hypothesis
The aim was to assess the efficacy of three-compartment pelvic organ prolapse (POP) vaginal repair using the InteXen® biocompatible porcine dermal graft as compared to traditional colporrhaphy with sacrospinous ligament suspension.Methods
Preoperative, operative, postoperative and follow-up data were collected retrospectively. Objective recurrence was defined as POP quantification ≥ stage II and subjective recurrence as a symptomatic bulge.Results
Each group consisted of 63 patients. Surgery time was longer using InteXen® (72?±?24.5 vs 55?±?23.5 min, p?=?0.0002). Length of hospital stay (4.6?±?1.6 vs 4.9?±?2.1 days, p?=?0.34) as well as duration of follow-up (37.1 vs 35.7 months, p?=?0.45) were equivalent between the two groups. No case of mesh erosion or infection was noted. The objective (17% vs 8%, p?=?0.12) and subjective recurrence rates (13% vs 5%, p?=?0.12) between the two groups were not statistically different.Conclusions
InteXen® was well tolerated but had similar efficacy to traditional colporrhaphy and sacrospinous ligament suspension. 相似文献20.
Alexander Fritzkarl Hagel Andreas Naegel Annette Simone Lindner Hermann Kessler Klaus Matzel Wolfgang Dauth Markus Friedrich Neurath Martin Raithel 《Journal of gastrointestinal surgery》2012,16(11):2132-2138