Heterogeneity of weight loss after gastric bypass,sleeve gastrectomy,and adjustable gastric banding

Background

Laparoscopic Roux-en-Y gastric bypass, laparoscopic sleeve gastrectomy, and laparoscopic adjustable gastric banding all lead to substantial weight loss in obese patients. Long-term weight loss can be highly variable beyond 1-year postsurgery. This study examines and compares the frequency distribution of weight loss and lack of treatment effect rates after laparoscopic Roux-en-Y gastric bypass, laparoscopic sleeve gastrectomy, and laparoscopic adjustable gastric banding.

Examination of the effects of hemodynamic and pharmacologic interventions on coronary collateral flow in a patient during cardiac catheterization

The vasomotor response of native human collateral vessels to pharmacologic or hemodynamic vasodilatory stimuli is not well known. We describe a case where retrograde collateral flow velocity was measured both at baseline and following selected hemodynamic and pharmacologic interventions. This index case represents the first in a series of potential human physiologic studies designed to address questions pertaining to control of collateral blood supply in humans. © 1993 Wiley-Liss, Inc.     

Fine needle aspiration cytology of lesions of the head and neck and factors affecting outcome

Fine Needle Aspiration Cytology (F.N.A.C.) has been used as a diagnostic tool by the ENT departments in Tayside since the end of 1985. This paper discusses the results of our initial experience with this and outlines some of the diagnostic pitfalls. This is a useful and accurate procedure with many advantages over diagnostic biopsy.     

Neuronal cell bodies in the hypothalamic paraventricular nucleus mediate stress-induced renin and corticosterone secretion

The present studies were undertaken to determine the involvement of neurons in the hypothalamic paraventricular nucleus (PVN) in stress-induced renin secretion. The stressor was a 10-min conditioned emotional response (CER) paradigm. Bilateral electrolytic lesions in the PVN prevented the stress-induced increase in plasma renin activity (PRA), and plasma renin concentration (PRC). Stress-induced corticosterone secretion was also blocked, supporting the histological verification and suggesting that the lesion included corticosterone-releasing factor neurons in the PVN. Stress-induced renin secretion appears to be restricted to the PVN, as electrolytic lesions in the nucleus reuniens, dorsal and caudal to the PVN, did not prevent the stress-induced increase in either PRA or PRC. The next step was to determine whether cell bodies in the PVN or fibers of passage through the PVN mediate the stress-induced increase of these hormones. For this purpose, bilateral stereotaxic injections of the cell-selective neurotoxin ibotenic acid (10 micrograms/microliter; 0.3 microliters per side) were performed 14 days prior to the stress procedure. Histological evaluation of the tissue revealed cell death and lysis in the PVN. Ibotenic acid injection into the PVN prevented the effect of stress on PRA, PRC and corticosterone levels. None of the lesions prevented the stress-induced rise in plasma prolactin concentration. These results suggest that neurons in the PVN play an important role in mediating stress-induced increases in renin and corticosterone but not prolactin secretion.     

Risk Factors for a First Febrile Seizure: A Matched Case-Control Study

Summary We conducted a matched casecontrol study to identify risk factors for first febrile seizures, with special emphasis on characteristics of the acute illness episode. Cases were identified through hospital emergency departments; controls were identified through outpatient clinics and emergency departments. Sixtynine children with first febrile seizures and no history of previous unprovoked seizures were matched for age (±6 months), site of routine pediatric care, and date of visit (±weeks) with 1 or 2 febrile controls who had no history of previous febrile or unprovoked seizures. Medical records for the index visit were reviewed, and parents were interviewed by telephone. Illness characteristics examined included height of temperature, type of underlying illness, contact with a physician during the illness but before the index visit, and use of acetaminophen or decongestants. Family history of febrile and of unprovoked seizures, sociodemographic characteristics, daycare use, and selected preand perinatal variables were also studied. On multivariable analysis, significant independent risk factors were height of temperature, history of febrile seizures in a firstor in a higher degree relative. Gastroenteritis as the underlying illness had a significant inverse (i.e., protective) association with febrile seizures. Maternal smoking during pregnancy was a marginally significant predictor of febrile seizures.