Stoma Adjustable Silicone Gastric Banding versus Vertical Banded Gastroplasty for the Treatment of Morbid Obesity

Background: Among gastric restrictive operations, the procedure of choice is still controversial. The aim of this study is to compare the results of two different gastric restrictive procedures: vertical banded gastroplasty (VBG) and stoma adjustable silicone gastric banding (ASGB). Methods: Between 1991 and 1996, 51 patients were treated surgically for morbid obesity: 27 underwent VBG and 24 underwent ASGB. Preoperative body weight (BW), body mass index (BMI) and percentage of ideal body weight (% IBW) were (mean ± SD): 145.7 ± 45.3 kg; 53.9 ± 15.9 kg/m²; 249.1 ± 73.5% respectively in the VBG group. Corresponding figures for the ASBG group were 132.5 ± 22.7 kg; 46.9 ± 7.8 kg/m² and 207.2 ± 35.0%. Results: In the VBG group, the median follow-up period was 26 months (range: 7-47). Eighteen months after the operation BW, BMI, % IBW and percentage of excess weight loss (% EWL) were 85.5 ± 26.8 kg, 31.9 ± 9.8 kg/m², 145.4 ± 43.9% and 74 ± 1% respectively. Complications included incisional hernia (n = 1), and bowel obstruction (n = 1). One patient died of acute myocardial infarction on the third postoperative day. In the ASGB group, median follow-up time was 19.7 months (range: 18-26). At 18 months postoperation BW, BMI, % IBW and % EWL values were 86.6 ± 20.6 kg 30.6 ± 6.6 kg/m2 140.6 ± 29.3% and 64 ± 1% respectively. Gastric wall erosion occurred in two patients and the bands had to be removed. These patients underwent VBG 6 months later. Complications encountered in this group were incisional hernia (n = 1), outlet stenosis and reflux esophagitis (n = 1), reservoir leakage (n = 1) and gastrointestinal bleeding (n = 1). Two patients died of pulmonary embolism and acute gastrointestinal bleeding. Conclusions: Weight reduction was not statistically significant between the two groups. ASGB was easier to perform and less invasive than VBG.     

Cytokeratin contents of basal cell carcinoma, epidermis overlying tumour, and associated stromal amyloidosis: an immunohistochemical study.

Cytokeratins (CKs) are expressed specifically in the cytoplasm of epithelial cells. We investigated the expression of CKs immunohistochemically in basal cell carcinomas (BCCs), epidermis overlying tumour, and skin tumor-associated amyloidosis (STA). Twenty cases of BCC, 11 of which had STA were included to the study. The primary antibodies of CK1-8 (AE3), CK10 (DEK-10), CK14 (LL002), CK17 (E3), CK18 (DC10), CK19 (KS19.1), CK 5/6/18 (LP34), CK8/18 (5D3) were applied to the section immunohistochemically. In BCCs without STA, CK1-8, CK14 and CK17 antibodies were expressed by tumour tissue in all biopsy specimens. In the BCCs with STA, tumour tissue was immunoreactive always with CK1-8 and CK17 antibodies, and commonly immunoreactive with anti-CK 14 antibody. In the epidermis overlying tumour tissue, there was positive immunoreactivity with anti-CK 1-8, CK 5/6/18, CK 10 and CK 14 antibodies in all biopsy specimens. Anti-CK 17 antibody was also positive in 17 biopsy specimens. STA is immunoreactive with anti-CK1-8 in all specimens. There was mild staining with anti-CK5/6/18 and with anti-CK19 whereas no immunoreactivity with anti-CK10 and CK18 antibodies was found. In conclusion, we could not find a significant CK expression difference between BCCs with and without STA. Weak positivity and a few number of CKs were shown in STA when compared with those of BCC and epidermis overlying tumour tissue expressing the more variable CKs. Interestingly, although CKs coexpressed in pairs consisting of one basic and one acidic CK, we detected predominantly basic CKs in STA.     

Immunophenotypic analysis of human spleen compartments.

Microanatomical compartments of the human spleen are yet under evaluation as most of the present information comes from experiments on animals with different anatomical structures. Immune staining of stromal and blood-born cells by cell surface antigens facilitates the differentiation of functional microanatomical compartmentalization of immune organs, including the spleen. Twenty-two specimens from healthy adult subjects with the average age of 35.6 +/- 13.8 (Range 17 to 58) years were included in this study. Monoclonal antibodies used in this study were supplied from the 5th, 6th and 7th International Workshops and Conferences on Human Leukocyte Differentiation Antigens. Tetraspan antigens presented a rather unique staining pattern in the human spleen, suggesting special roles for each (CD9, CD53, CD63, CD151 and CD231) in certain locations. Sinus lining cells presented a distinctive antigenic profile, sharing both endothelial cell (CD31, CD36, CD54, CD62P, CD102, CD105, CD106 and CD146) and macrophage lineage characteristics. The sheathed capillaries were not restricted to the perifollicular zone alone. Extracellular matrix receptors (CD49 a, CD49 b, CD49 c, CD49 e, CD49f, CD29 and CD44) stained the penicillary arterioles and vascular smooth muscle. These molecules were also found on the vascular endothelium. Leukocyte antigens (CD11a, CD11b, CD22, CD43, CD45, CD45RB, CD45RO and CD50) were mainly expressed in the white and red pulp of the spleen at different intensities, excluding the penicillary arterioles. Activation antigens (CD26, CD71 and CD98) presented a diffuse and broad staining pattern. In conclusion, microanatomical compartmentalization, microcirculation and function of the human spleen were evaluated using a wide panel of monoclonal antibodies.     

Effects of probucol in hyperlipidemic rabbit liver: a preliminary ultrastructural study

Probucol is a lipid-lowering agent with an antioxidant effect; however, its influence on the liver remains unclear. The effects of probucol on hyperlipidemic rabbit liver are investigated to add a structural data on its therapeutical profile. Local albino rabbits were divided into three groups. 1) Hyperlipidemic group: fed with 1% cholesterol (150 g/kg/day) enriched chow for 2 months. 2) Probucol treated group: group 1 + intraperitoneal probucol (10 mg/kg/day) administration for 15 days. 3) Control group fed with normal chow. The blood lipid profile was investigated biochemically. Liver samples were examined electronmicroscopically. Within the parenchymal cells of group 1, the amount of rough surfaced endoplasmic reticulum was increased, its cisterna was dilated displaying a moderately electron dense substance in it and showed close apposition with the condensed mitochondria. In group 2, smooth surfaced endoplasmic reticulum was in extensive amounts filling almost all of the cytoplasm, displayed a reticular, degenerated appearance and was in close relation with the condensed, degenerated mitochondria. Probucol may cause degenerative changes on the liver parenchyme at the subcellular level. It alters the structure of these cells mainly acting on the smooth surfaced endoplasmic reticulum and the mitochondria that are known to be involved in cellular detoxification.     

Collagen-chondroitin sulfate-based PLLA-SAIB-coated rhBMP-2 delivery system for bone repair

Bone morphogenetic proteins (BMPs) are osteoinductive proteins used intensively in clinical investigations involving various bone-related treatments. Owing to their high potential in new bone formation they require local application at the treatment site. For this purpose various controlled delivery systems with BMPs as the excipients have been prepared in recent years. Focusing on this clinical need a disc-shaped BMP carrier was designed as a local delivery system using soluble collagen and chondroitin sulfate. In situ release studies carried out with a model protein (FITC-labeled Protein A) presented a very high rate of release; with most of the protein content being released within 24 h. This rate could be decreased by providing a poly(L-lactide) (PLLA) and sucrose acetate isobutyrate-based (SAIB-based) coat around the release system, applied after BMP loading. In this way, it was possible to extend the release period from 24 h to about 12 days. In situ release of BMP from the same carriers, as quantitated using an ELISA kit, was even slower, with 50% of the protein being released in 15 days. In order to be able to secure the BMP delivery system at the bone defect site and to provide support a mesh knitted using Vicryl sutures and bonded with poly(L-lactide-co-glycolide) (PLGA) was tested in in vivo. Two time periods, 1 and 3 weeks, were used to evaluate the healing process. Osteoinduction by the BMP carrier system was assessed by histology-based bone scoring and X-ray examinations. PLLA-SAIB-coated collagen discs containing BMP presented good biocompatibility and optimum osteogenic stimulation. Structural changes in histological micrographs at week 1 indicated dose-dependent periosteal ossification. At the end of week 3 histological findings with both BMP (1 and 2 microg) doses were almost the same.     

Effect of arachidonic acid on specific binding of [3H]naloxone to opioid receptors

The effects of arachidonic acid (AA) on binding of [3H]naloxone to the agonist and antagonist configurations of opioid receptors were investigated in rat brain. Equilibrium binding parameters of the agonist and antagonist configurations of the receptors were evaluated from homologue displacement data in the presence or absence of AA. Addition of AA at a concentration of 0.6 mM (1.5 mumole/mg of protein) reduced by 22% and 53% the maximal number of binding sites (Bmax) respectively in the absence or presence of 100 mM NaCl. Binding affinity (KD) was not altered significantly (P < 0.05) either in the presence or absence of 100 mM NaCl and AA. We conclude that AA mediated reduction in [3H]naloxone specific binding was chiefly due to a decrease in the number of binding sites.     

Inactivation of a turkey herpesvirus by ultra-violet light

The sensitivity to inactivation by ultraviolet light of the PB 1 strain of herpesvirus of turkeys (HVT) was determined and compared with the relative sensitivity of pseudo-rabies virus (PRV), another member of the herpesvirus group. HVT (PB1) was 6.3 times more resistant than PRV when assayed in chick embryo fibroblasts. The survival curve of HVT (strain PB1) had one component and the survival curve of PRV had two components. Survival curves of HVT and PRV in chick embryo fibroblasts treated with caffeine and in duck embryo fibroblasts are also presented. Evidence was obtained for host cell reactivation of HVT and PRV in chick embryo fibroblasts. Multiplicity reactivation could be clearly demonstrated for UV-irradiated PRV, but not for HVT.     

Antioxidative vitamin treatment: Effect on lipid peroxidation and limb swelling after revascularization operations

The objective of this study was to evaluate the antioxidative properties of the multivitamin cocktail Omnibionta^® (-tocopherol, ascorbic acid, retinol, vitamin B complex) in terms of diminishing lipid peroxidation with improvement of leg edema performance after limb revascularization operations in humans. Fifty-one subjects were selected; the control group contained 27 patients and the treatment group 24 patients, who received the vitamin cocktail intravenously before the start of reperfusion. All patients suffered from acute or chronic arterial occlusive disease, except two subjects with arterial trauma. MDA-TBARS in plasma, quantified by HPLC, taken as a measure of lipid peroxidation was significantly increased (p<0.001) in the control group 1 hour after reperfusion onset and decreased to its baseline value within the following 2 hours (0.73±0.26, 1.21±0.48, 0.99±0.48, 0.73±0.33 nmol/ml). In contrast, in the treatment group MDA-TBARS did not exceed the baseline value during the reperfusion period (0.93±0.30, 0.70±0.29, 0.65±0.23, 0.70±0.37 nmol/ml). Leg edema, expressed by extremity circumference, was significantly (p<0.008) elevated in the control group (30.7±4.04 cm versus 35.35±4.12 cm) compared to a lack of increase in the treatment group (29.25±5.13 cm versus 29.76±5.70 cm). These results suggest that antioxidative vitamin treatment might be valuable in preventing lipid peroxidation and decreasing extremity edema.

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Resumen El objeto del presente estudio fue evaluar las propiedades antioxidantes del coctel multivitamínico Omnibionta^® que contiene las vitaminas -tocoferol, ácido ascórbico, retinol y el complejo B, en cuanto a disminuir la peroxidación lipídica y reducir el edema en las operaciones de revascularización de extremidades en humanos. Se seleccionaron 51 individuos: el grupo control de 27 pacientes y el grupo de tratamiento de 24 pacientes que recibieron el coctel multivitamínico por vía intravenosa antes del comienzo de la reperfusión. Todos los pacientes exhibían enfermedad arterial oclusiva aguda o crónica, excepto 2 pacientes con trauma arterial. Se hicieron determinaciones de MDA-TBARS en el plasma, cuantificado por HPLC, como medida de la peroxidación lipídica, encontrándose que se hallaba significativamente aumentada (p<0.001) en el grupo control 1 hora luego del comienzo de la reperfusión y que descendió hasta los niveles basales en el curso de las siguientes 2 horas (0.73±0.26, 1.21±0.48, 0.99±0.48, 0.73±0.33 nmol/ml). El edema de la pierna, según la circunferencia de las extremidades, apareció significativamente elevado (p<0.008) en el grupo control (30.7±4.04 vs. 35.35±4.12 cm) en comparación con el ningún aumento en el grupo de tratamiento (29.25±5.13 vs. 29.76±5.70 cm). Tales resultados sugieren que el tratamiento vitamínico antioxidante puede ser de valor en la prevención de la peroxidación lipídica con disminución del edema de la extremidad.

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Résumé L'objectif de cette étude a été d'évaluer les propriétés antioxydatives du cocktail multivitamine Omnibiota^®, contenant les vitamines -tocophérol, de l'acide ascorbique, du rétinol et du complexe vitamine B, pour diminuer les peroxydations lipidiques et améliorer l'oedème de jambe après reconstruction vasculaire chez l'homme. Cinquante et un sujets ont été sélectionnés, 27 formant le groupe témoin, et 24 patients recevant le cocktail en intraveineux avant la reconstruction vasculaire. Tous les patients avaient une maladie artérielle occlusive chronique, sauf deux qui souffraient d'un traumatisme artériel. Le MDA-TBARS dans le plasma, quantifié par HPLC, comme mesure de la peroxydation lipidique, était significativement augmenté (p<0.001) dans le groupe contrôle une heure après le début de la reperfusion et a diminué jusqu'aux valeurs du départ dans les deux heures suivantes (0.73±0.26, 1.21±0.48, 0.99±0.48, 0.73±0.33 nmol/ml). Dans le groupe traité, le MDA-TBARS n'a pas dépassé les valeurs de base pendant la période de reperfusion (0.93±0.30, 0.70±0.29, 0.65±0.23, 0.70±0.37 nmol/ml). L'oedème des membres inférieurs, exprimé en circonférence de l'extrémité de la jambe, était signficativement plus augmenté (p<0.008) dans le groupe contrôle (30.7±4.04 vs. 35.35±4.12 cm) que dans le groupe traité (29.25±5.13 vs 29.76±5.70 cm). Ces résultats suggèrent que le traitement vitaminique antioxydatif pourrait être utile dans la prévention de la peroxydation lipidique, réduisant ainsi l'oedème des extrémités.