Port-site metastases after CO2 laparoscopy

BACKGROUND: Animal experiments have shown that carbon dioxide (CO(2)) laparoscopy results in more port-site recurrences than gasless laparoscopy. Possible transport of aerosolized tumor cells by CO(2) was investigated in rats. METHODS: Abdominal cavities of 15 pairs of Wistar Agouti (WAG) rats were connected and 2 x 10(6) or 16 x 10(6) CC 531 cells were injected in the first (donor) rat of each pair. Then 10 l of CO(2) were allowed to flow from the first (donor) to the second (recipient) rat. RESULTS: No tumor was found in the recipients after injection of 2 x 10(6) cells in the donors. Injection of 16 x 10(6) cells in the donors resulted in very limited tumor growth in the recipients. CONCLUSIONS: Aerosolization of tumor cells occurs, but the number of intraperitoneal tumor cells required for metastases to occur by this mechanism is extremely high. Therefore, aerosolization of tumor cells appears not to be of major relevance in the pathogenesis of port-site metastases.     

Cerebrovascular CO2 reactivity after carotid artery occlusion

Cerebral blood flow (CBF) was measured in 39 men at normocapnia and after 5% CO2 inhalation using the xenon-133 technique. Twenty-three patients had unilateral carotid artery occlusion with no angiographic evidence of contralateral carotid artery stenosis or ophthalmic collateral flow. Eleven of these patients had undergone extracranial-intracranial (EC-IC) bypass surgery. Sixteen age-matched normal men underwent CBF measurements at normocapnia and hypercapnia to provide control data. Mean hemispheric CBF was not different between hemispheres ipsilateral and contralateral to the carotid artery occlusion either in the patients who had undergone bypass surgery or in those with carotid artery occlusion alone. Considering all patients with carotid artery occlusion, mean CO2 reactivity was decreased in the hemisphere ipsilateral to the occlusion as compared to the contralateral hemisphere in both groups. Based on data from normal individuals, a hemispheric difference in CO2 reactivity of more than 0.94%/mm Hg PaCO2 or a global CO2 reactivity of less than 0.66%/mm Hg PaCO2 was considered abnormal for an individual patient. Six of 23 patients with carotid artery occlusion (three with an EC-IC bypass) had global or hemispheric abnormalities in CO2 reactivity. Patients with impaired CO2 reactivity were not distinguishable from other patients by neurological examination, presence of transient ischemic attacks, or evidence of infarction on computerized tomography scanning. This test was safe and simple to perform and may be a useful means of detecting impaired cerebrovascular collateral reserve capacity. If impaired CO2 reactivity after carotid artery occlusion proves to be associated with a high risk of subsequent stroke, the test would provide a physiological basis for selecting a subgroup of patients who could be helped by cerebral revascularization.     

Postoperative interstitial pneumonia: 2 cases after lobectomy

Two patients with postoperative interstitial pneumonia are reported. Preoperative diagnosis was primary lung cancer without idiopathic interstitial pneumonia (IIP). Within one week after operation acute interstitial pneumonia (AIP) occurred on the nonoperated side and developed. Steroid therapy was performed but one was dead. AIP is a fatal complication after pulmonary resection and steroid therapy may be useful in some cases of postoperative AIP.     

CO2 reactivity in patients after subarachnoid haemorrhage

Summary CO₂ reactivity was tested in patients with transcranial Doppler sonography (TCD) and endtidal CO₂ measurements after an average time interval of ten months after subarachnoid haemorrhage (SAH). After deliberately changing breathing there was a significant change in endtidal CO₂ and in flow velocities in all three examination groups. Comparing 27 patients with SAH and 5 patients treated for incidential aneurysms and 20 patients without cerebrovascular disease there were no significant differences in CO₂ reactivity. Furthermore, there were no right to left differences. In 12 patients with vasospasm, two of them treated by percutaneous transluminal angioplasty for delayed ischaemic deficits, CO₂ reactivity was normal at the time of investigation. Furthermore, normal CO₂ reactivity was found in patients after SAH and surgery for ruptured aneurysms regardless of the severity of the SAH.     

Obstetric outcomes after restrictive bariatric surgery: What happens after 2 consecutive pregnancies?

BackgroundThe objective of this study was to compare the outcomes of 2 consecutive pregnancies of the same women who conceived after restrictive bariatric surgeries.MethodsA retrospective study comparing consecutive pregnancy outcomes of the same women, who conceived before and twice after a restrictive bariatric surgery, was conducted.ResultsThis study included 109 women, and therefore, 327 paired pregnancies: 109 pregnancies preceded and 218 followed restrictive bariatric surgery (87% had laparoscopic banding, and 13% had silastic ring vertical gastroplasty). Both prepregnancy and predelivery body mass index were significantly lower after bariatric surgery (36.7±4.4 versus 31. 5±5.5, P<.001; 40.6±5.5 versus 35.3±6.1, P<.001; respectively). This effect was preserved at the subsequent pregnancy (31.5±5.5 versus 31.3±6.3, P = .609, and 35.3±6.1 versus 35.1±5.9, P = .706, respectively). The rates of hypertensive disorders and gestational diabetes mellitus were significantly lower after the bariatric operation, for the first and the second pregnancy (21% versus 7.4% and 4.7%, P = .009, and 19% versus 5.6% and. 6.6%, P = .007, respectively). The rate of macrosomic newborn was significant lower in the second postbariatric pregnancy (11.1% before versus 1.1% after second pregnancy, P = .02). Using multiple logistic regression models controlling for maternal age, prepregnancy body mass index, and the type of surgery, the reduction in hypertensive disorders (adjusted odds ratio (OR) .3, 95% confidence interval (CI) .12–.82; P = .018 for the first postoperative pregnancy and adjusted OR .2, 95% CI .06–.64; P = .007 for the second postoperative pregnancy), and gestational diabetes mellitus (adjusted OR .2, 95% CI .06–.48; P = .001 for the first postoperative pregnancy and adjusted OR .3, 95% CI .05–.51; P = .002 for the second postoperative pregnancy) remained significant.ConclusionsA significant decrease in pregnancy complications, such as hypertensive disorders and gestational diabetes mellitus, is achieved after a restrictive bariatric surgery. This improvement is maintained at the second subsequent pregnancy.     

H2O2诱导的肝星状细胞凋亡后胶原的变化

Objective To explore the changes of collagen (COL) Ⅰ and COLⅢ after apoptosis of HSC induced by H2O2. Methods Different apoptosis rate of HSC-T6 induced by H2O2 ( 100 nmol/L) was evaluated by flow cytometry. RT-PCR was used to detect the gene expression levels of COL Ⅰ and COL Ⅲ. Results Apoptosis of HSC was induced by 100 nmol/L H2O2 with the poptosis rate being 5.86%, 58.55% ,and 71.98% ,respectively. The COL Ⅰ and COLⅢ were highly expressed in activated HSC,and decreased sharply as apoptosis increased. The changes in gene expression of COL Ⅰ were much more obvi-ous than those of COL Ⅲ. Conclusion Inducing apoptosis of HSC may decrease the gene expression of collagens.     

Resolution of type 2 diabetes after sleeve gastrectomy: a 2-step hypothesis

Background

Weight loss (WL) and altered gut hormonal levels are involved in glucose homeostasis after laparoscopic sleeve gastrectomy (LSG).

H2O2诱导的肝星状细胞凋亡后胶原的变化

Objective To explore the changes of collagen (COL) Ⅰ and COLⅢ after apoptosis of HSC induced by H2O2. Methods Different apoptosis rate of HSC-T6 induced by H2O2 ( 100 nmol/L) was evaluated by flow cytometry. RT-PCR was used to detect the gene expression levels of COL Ⅰ and COL Ⅲ. Results Apoptosis of HSC was induced by 100 nmol/L H2O2 with the poptosis rate being 5.86%, 58.55% ,and 71.98% ,respectively. The COL Ⅰ and COLⅢ were highly expressed in activated HSC,and decreased sharply as apoptosis increased. The changes in gene expression of COL Ⅰ were much more obvi-ous than those of COL Ⅲ. Conclusion Inducing apoptosis of HSC may decrease the gene expression of collagens.     

H2O2诱导的肝星状细胞凋亡后胶原的变化

Objective To explore the changes of collagen (COL) Ⅰ and COLⅢ after apoptosis of HSC induced by H2O2. Methods Different apoptosis rate of HSC-T6 induced by H2O2 ( 100 nmol/L) was evaluated by flow cytometry. RT-PCR was used to detect the gene expression levels of COL Ⅰ and COL Ⅲ. Results Apoptosis of HSC was induced by 100 nmol/L H2O2 with the poptosis rate being 5.86%, 58.55% ,and 71.98% ,respectively. The COL Ⅰ and COLⅢ were highly expressed in activated HSC,and decreased sharply as apoptosis increased. The changes in gene expression of COL Ⅰ were much more obvi-ous than those of COL Ⅲ. Conclusion Inducing apoptosis of HSC may decrease the gene expression of collagens.     

H2O2诱导的肝星状细胞凋亡后胶原的变化

Objective To explore the changes of collagen (COL) Ⅰ and COLⅢ after apoptosis of HSC induced by H2O2. Methods Different apoptosis rate of HSC-T6 induced by H2O2 ( 100 nmol/L) was evaluated by flow cytometry. RT-PCR was used to detect the gene expression levels of COL Ⅰ and COL Ⅲ. Results Apoptosis of HSC was induced by 100 nmol/L H2O2 with the poptosis rate being 5.86%, 58.55% ,and 71.98% ,respectively. The COL Ⅰ and COLⅢ were highly expressed in activated HSC,and decreased sharply as apoptosis increased. The changes in gene expression of COL Ⅰ were much more obvi-ous than those of COL Ⅲ. Conclusion Inducing apoptosis of HSC may decrease the gene expression of collagens.     

H2O2诱导的肝星状细胞凋亡后胶原的变化

目的 观察Ⅰ型胶原(COL Ⅰ)和Ⅲ型胶原(COLⅢ)在H2O2诱导的肝星状细胞(HSC)凋亡后的变化.方法 用流式细胞术检测100 nmol/L的H2O2诱导HSC不同程度的凋亡;应用半定量逆转录-聚合酶链反应(RT-PCR)检测细胞内COL Ⅰ、COLⅢ mRNA的表达及变化.结果 用100 nmol/L H2O2诱导HSC凋亡(凋亡率分别5.86%、58.55%、71.98%),COL Ⅰ、COL Ⅲ在活化的HSC-T6细胞内均高表达,且伴随凋亡的增加,表达急剧下降,COL Ⅰ的变化更明显.结论 诱导HSC凋亡可减少胶原基因的表达.     

H2O2诱导的肝星状细胞凋亡后胶原的变化

Objective To explore the changes of collagen (COL) Ⅰ and COLⅢ after apoptosis of HSC induced by H2O2. Methods Different apoptosis rate of HSC-T6 induced by H2O2 ( 100 nmol/L) was evaluated by flow cytometry. RT-PCR was used to detect the gene expression levels of COL Ⅰ and COL Ⅲ. Results Apoptosis of HSC was induced by 100 nmol/L H2O2 with the poptosis rate being 5.86%, 58.55% ,and 71.98% ,respectively. The COL Ⅰ and COLⅢ were highly expressed in activated HSC,and decreased sharply as apoptosis increased. The changes in gene expression of COL Ⅰ were much more obvi-ous than those of COL Ⅲ. Conclusion Inducing apoptosis of HSC may decrease the gene expression of collagens.     

H2O2诱导的肝星状细胞凋亡后胶原的变化

Objective To explore the changes of collagen (COL) Ⅰ and COLⅢ after apoptosis of HSC induced by H2O2. Methods Different apoptosis rate of HSC-T6 induced by H2O2 ( 100 nmol/L) was evaluated by flow cytometry. RT-PCR was used to detect the gene expression levels of COL Ⅰ and COL Ⅲ. Results Apoptosis of HSC was induced by 100 nmol/L H2O2 with the poptosis rate being 5.86%, 58.55% ,and 71.98% ,respectively. The COL Ⅰ and COLⅢ were highly expressed in activated HSC,and decreased sharply as apoptosis increased. The changes in gene expression of COL Ⅰ were much more obvi-ous than those of COL Ⅲ. Conclusion Inducing apoptosis of HSC may decrease the gene expression of collagens.