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91.
A prospective study of biochemical changes after vertical banded gastroplasty for morbid obesity, in 94 patients (10 males
and 84 females, ages ranging from 18 to 59 years) has been carried out. Liver function tests and electrolyte estimations were
performed preoperatively, during hospitalisation for surgery, at 6 weeks and at 6 months postoperatively, and demonstrated
no significant changes in liver function in these patients 6 months after surgery. The study concludes that there is no increase
in the risk of liver damage or electrolyte disturbance after vertical gastroplasty, but that there may be subtle hepatic changes
present as gall bladder disease developed in 18 patients postoperation (19%). 相似文献
92.
A retrospective study of all ileogastrostomy procedures (n=26) performed in 1993 by one surgeon (IGMC) was carried out to investigate the hypothesis that Helicobacter pylori may be implicated in certain severe cases of postoperation nausea and diarrhea. Ten of 26 persons (38.5%) displayed nausea
and notable diarrhea (greater than or equal to ten bowel movements per day), seven of which warranted upper GI investigation.
One hundred per cent (seven of seven) of these persons were found to possess H. pylori upon C-14 breath test. In four of six cases eradication therapy (1 g amoxicillin b.i.d./20 mg omeprazole b.i.d. for 2 weeks)
corresponded with a resolution of severe nausea and diarrhea (one additional case involved omeprazole use only), suggesting
that H. pylori should be considered as a possible cause of these symptoms post-ileogastrostomy. Additionally, in four of seven cases persons
were re-tested (C-14 breath analysis) at least 1 month post-therapy and in this group three persons were found to be free
of the organism. All three cases of notable diarrhea and nausea resolved with treatment, providing the strongest evidence
for a possible association between infection and these symptoms. 相似文献
93.
Background: this study was designed to characterize some of the biochemical and molecular genetic changes during reversion
of human fat cells. Methods: mature adipocytes were isolated from greater omental fat tissue of eight lean and 14 massively
obese persons by established methodology. Results: at day 7 of adherence to Leighton tubes, there was appreciable depletion
of triacylglycerol, as well as assumption of an elongated contour. Relatedly, there was an increase in the expression of β-actin
mRNA and a significant decrease in the specific activity of cytosolic glycerophosphate dehydrogenase. The decrement in the
specific activity of glycerophosphate dehydrogenase, after 7 days in culture, was significant at p < 0.001. Basic fibroblast growth factor at 10 ngml-1 accelerated significantly (p < 0.03) the decrease in the specific activity of glycerophosphate dehydrogenase in adipose cells from lean subjects. In contrast,
basic fibroblast growth factor had no significant influence on cells from massively obese persons. Conclusion: such resistance
may contribute to the intractability of massive obesity. 相似文献
94.
Background: Vitamin B12 deficiency after gastric surgery for obesity is due to a failure of separation of vitamin B12 from protein foodstuffs and to a failure of absorption of crystalline vitamin B12 in the presence of intrinsic factor. The purpose of this study was to determine which of four oral doses of crystalline vitamin
B12 was most effective in treating vitamin B12 deficiency in 102 patients. Methods and Results: At time of entry into the study, the patients had a serum vitamin B12 < 100 pmol L −1, were 29.9 ± 21.7 months post-op, were 37 ± 8 years old and had a body mass index of 30 ± 6 kg m−2. Eight (8%) had had a vertical banded gastroplasty and 94 (92%) a gastric bypass. For the first 3 months all patients received
350 μg per day of crystalline vitamin B12 and all increased their serum vitamin B12 levels to over 100 pmol L−1. The patients were then assigned to receive for a further 3 month period one of four oral doses of crystalline vitamin B12-100 μg, 250 μg, 350 μg and 600 μg. Serum vitamin B12 levels were greater than 150 pmol L−1 after 6 months in 83.3% of patients who received 100 μg; 92.3% of patients who received 250 μg; 94.7% after 350 μg and 95.2%
after 600 μg (p%0.525). Conclusion: At least 350 μg per day is the appropriate oral dose of crystalline vitamin B12 after gastric surgery for obesity to correct low serum vitamin B12 levels in 95% of patients. 相似文献
95.
Macgregor AM 《Obesity surgery》1996,6(4):325-329
Long-term results of bariatric surgery are reviewed. The weight criteria for patient acceptance for bariatric surgery and
their variation are presented graphically and discussed. Factors affecting patient selection in an attempt to improve outcome
results in the small group of patients who currently achieve less weight loss than anticipated are defined. An attempt is
made to define pre-operative criteria for selection of pure restrictive versus combined restrictive and malabsorptive procedures.
Aspects of motivation, co-morbidity, age and pre-operative weight are discussed and the position statement of the ASBS in
regard to laparoscopic bariatric surgery is defined. 相似文献
96.
James J. R. Kirkpatrick MA FRCS FRCSEd ; Bert Curtis BCom BA ; Ian L. Naylor PhD MRPharmS 《Wound repair and regeneration》1996,4(3):326-334
The European Renaissance was a time of enormous change and rapid progress in the arts, sciences, and medicine. A glimpse of wound care in the last phase of the European Renaissance is provided by the analysis of work by Wilhelm Fabry, the "father of German surgery," as provided in his book De Combustionibus ("Burns") which details his range of treatments for the burn wound, as well as his approach to the later problems of scarring and contracture. We describe some of the historic events which may have stimulated Fabry's writings, in particular, the influences passed down from the medical school of Padua which thereby advanced the cause of wound care and surgery. Finally, we briefly explore the potential of such an approach to the works of our medical forefathers. 相似文献
97.
Summary Twenty-five digital webs from 21 patients, where web creep was noted after division of simple syndactyly were reviewed. In all cases web creep was related to delayed healing and the average time to its appearance was 8 months. 相似文献
98.
A recent review of the results of gastroplasties done at the University of Alberta Hospital showed that there was a high incidence
of late weight loss failure. Therefore a new operation, gastroplasty/distal gastric bypass, has been performed on 263 patients.
This operation results in a profound (mean greatest percentage excess weight loss of 87% at approximately 2 years) and lasting
weight loss (mean final percentage excess weight loss of 78%) at 4 years, range 2-7.5 years post-operatively. Only 0.9% of
patients failed to maintain at least a 40% excess weight loss. The operation achieves its effect through a moderate restriction
that permits patients to eat normal table food from the time of discharge and with a mild malabsorption that is not ordinarily
associated with diarrhea or notable deficiencies. Certain patients required debanding of the stoma and others developed staple-line
eventration. Neither of these events after long-term follow-up resulted in weight loss failure nor in other serious side-effects.
It is concluded that moderate failure of the gastroplasty stoma and staple line does not necessarily result in weight loss
failure, because the malabsorptive portion of the operation remains intact. Low hemoglobin occurred in 16% of cases and deficiency
of serum iron in 34%; a much smaller number of patients had chronic or intermittent deficiencies of these entities. Correction
was easily achieved with oral replacement. Deficiencies in albumin, calcium, phosphorus and folate were rarely seen and minimal
elevation of serum AST values occurred in just over 1% of patients. Chronic deficiencies or elevations were not seen in these
patients. Stomal ulcer occurred in 6% of patients and bleeding associated with stomal ulcer in 1%. Half the patients with
ulcer were managed with H2 blockers, the other half with vagotomy. Both forms of treatment when individualized effectively prevent re-ulceration. 相似文献
99.
Natham B 《Obesity surgery》1992,2(3):217-218
Medieval medical views on obesity are presented from Avicenna's Canon of Medicine. Health risks associated with obesity were appreciated, including respiratory and cardiovascular problems, infertility and
even sudden death. 相似文献
100.
The success of vertical gastroplasty may be jeopardized by gastric leakage or ulceration due to failure of the technique.
Reports of band erosion and staple-line leakage have led us to seek technical improvements to reduce technical failures. We
describe a modification to the technique of band placement and a manoeuvre to aid the placement of staples when the TA90 staple
gun is used. 相似文献