Management of gallstones and gallbladder disease in patients undergoing gastric bypass

The appropriate management of gallstones and gallbladder disease in patients undergoing gastric bypass remains unknown.Several therapeutic modalities are used and include performing cholecystectomy on all patients at the time of gastric bypass,performing concomitant cholecystectomy only when patients have gallstones and performing cholecystectomy only in the presence of both symptoms and gallstones.Some groups administer ursodeoxycholic acid for gallstone prevention in the postoperative period.All treatment...     

液化气扩散火焰的分形结构特征

基于图像处理方法和分型理论研究了液化气扩散火焰边缘分形结构特征。沿火焰轴向将火焰均分为5个区域,研究火焰边缘分形维数沿火焰轴向的变化,通过改变中心通道氧气速度,研究火焰长度、分形维数与过氧系数的关系。研究结果表明：随着过氧系数的增大,火焰长度逐渐缩短;火焰波动范围也减小,从喷嘴到火焰末端分形维数先减小后增大,并且变化范围不大。     

Laparoscopic Sleeve Gastrectomy as an Alternative to Gastric Bypass in Patients with Multiple Intraabdominal Adhesions

Background Laparoscopic sleeve gastrectomy and its indications are currently being evaluated. The objective of this study was to show the preliminary results obtained with this technique indicated as an alternative to gastric bypass in patients with multiple intraabdominal adhesions, therefore preserving the benefits of the laparoscopic approach. Methods An analysis of all patients who underwent a laparoscopic sleeve gastrectomy for the above indication was done. Data included demographics, number of previous surgeries, operative time, morbidity, mortality, and %EWL at 3 and 6 months. Results Fifteen patients underwent laparoscopic sleeve gastrectomy as an alternative to gastric bypass because of multiple intraabdominal adhesions. No patient required conversion to an open procedure; morbidity was 6% with no mortality. %EWL at 3 months was 41% and at 6 months was 44%. Mean follow-up was 6 months. Conclusion In our initial experience, laparoscopic sleeve gastrectomy proved to be a safe and effective alternative to gastric bypass for patients with multiple intraabdominal adhesions.     

Na(+)-Ca(2+) cosignaling in the stimulation of the glucose transporter GLUT1 in cultured astrocytes

Glutamate triggers an acute stimulation of the glucose transporter GLUT1 in cultured astrocytes, a phenomenon thought to facilitate energy delivery to active areas in the brain. Here we have explored the cell signaling mechanisms involved in this response. Half-stimulation of GLUT1 occurred at low micromolar glutamate, thus within the physiological range estimated in brain interstitium. The effect was mimicked by D-aspartate and inhibited by L-threo-beta-benzyloxyaspartate or Na(+) replacement with NMDG(+), showing the participation of the Na(+)-glutamate co-transporter. AMPA and the mGLURI agonist DHPG had no effect. The stimulation of GLUT1 was fully inhibited by ouabain, but independent activation of the Na(+)/K(+) ATPase pump with gramicidin did not affect glucose transport. Simultaneous with the Na(+) rise, glutamate and D-aspartate triggered a Ca(2+)signal, whose inhibition with BAPTA prevented the stimulation of GLUT1. However, an isolated Ca(2+) signal, triggered with endothelin 1, ATP or DHPG, did not affect glucose transport. The stimulation of GLUT1 could finally be mimicked by simultaneous induction of Na(+) and Ca(2+) signals. The requirement for both cations in the stimulation of the astrocytic glucose transporter, may help to explain how glucose metabolism in the brain is strongly activated by glutamate, but not by GABA or by inter-astrocytic signaling.