ABSTRACT
Objective@#To evaluate the application value of quantitative computed tomography for evaluation of changes in abdominal fat after laparoscopic Roux-en-Y gastric bypass in obese patients.@*Methods@#The retrospective and descriptive study was conducted. The clinical data of 52 obese patients who underwent laparoscopic Roux-en-Y gastric bypass in the Third Medical Center of Chinese PLA General Hospital from March 2011 to February 2012 were collected. There were 24 males and 28 females, aged (43±9)years, with the range of 23-62 years. All the 52 patients underwent laparoscopic Roux-en-Y gastric bypass. Observation indicators: (1) surgical and postoperative conditions; (2) changes in anthropometric indices; (3) follow-up. Follow-up using outpatient examination was performed to detect complications of patients at 1, 3, 6, 12 months after surgery up to February 2013. Measurement data with normal distribution were represented as Mean±SD, repeated measurement data were analyzed using repeated ANOVA. Count data were represented as absolute numbers.@*Results@#(1) Surgical and postoperative conditions: all the patients underwent laparoscopic Roux-en-Y gastric bypass successfully, without conversion to open surgery. The volume of intraoperative blood loss, operation time, and duration of hospital stay were (25±11)mL, (78±14)minutes, and (11±2)days. (2) Changes in anthropometric indices: the body mass index (BMI), fat mass, free fat mass, total abdominal fat volume (TAFV), total subcutaneous fat volume (TSFV), and total visceral fat volume (TVFV) of all the 52 patients were (31.8±1.8)kg/m2, (39.4±4.1)kg, (50.2±6.0)kg, (11 703±3 899)cm3, (7 418±2 969)cm3, and (4 314±1 692)cm3 before surgery, (28.5±1.4)kg/m2, (33.0±1.1)kg, (49.7±4.6)kg, (11 016±3 713)cm3, (7 044±2 970)cm3, (3 969±1 443)cm3 at 3 months after surgery, (27.1±1.7)kg/m2, (30.2±1.3)kg, (45.4±3.1)kg, (9 406±4 452)cm3, (6 442±3 307)cm3, and (2 964±1 694)cm3 at 6 months after surgery, (24.4±2.4)kg/m2, (32.6±1.1)kg, (48.6±2.7)kg, (7 612±3 029)cm3, (5 623±2 650)cm3, and (1 826±360)cm3 at 12 months after surgery, respectively, there were significant differences in the changes of these indices (F=130.2, 30.3, 4.9, 25.6, 11.9, 16.5, P<0.05). The BMI, fat mass, and TAFV at 3 months after surgery had significant differences compared with those before surgery (P<0.05), but free fat mass, TSFV, and TVFV had no significant difference (P>0.05). The BMI, fat mass, TAFV, and TVFV at 6 months after surgery had significant differences compared with those before surgery (P<0.05), but free fat mass and TSFV had no significant difference (P>0.05). The BMI, fat mass, TAFV, TSFV, and TVFV at 12 months after surgery had significant differences compared with those before surgery (P<0.05), but free fat mass had no significant difference (P>0.05). (3) Follow-up: all the 52 patients have completed the follow-up after surgery and the remission number of obesity was 35. No complications such as anastomotic hemorrhage, obstruction, or anastomotic leakage occured in all the 52 patients.@*Conclusion@#Laparoscopic Roux-en-Y gastric bypass can reduce abdominal visceral fat significantly, while quantitative computed tomography can help to evaluate the distribution of abdominal visceral fat accurately.
ABSTRACT
Objective To evaluate the application value of quantitative computed tomography for evaluation of changes in abdominal fat after laparoscopic Roux-en-Y gastric bypass in obese patients.Methods The retrospective and descriptive study was conducted.The clinical data of 52 obese patients who underwent laparoscopic Roux-en-Y gastric bypass in the Third Medical Center of Chinese PLA General Hospital from March 2011 to February 2012 were collected.There were 24 males and 28 females,aged (43±9)years,with the range of 23-62 years.All the 52 patients underwent laparoscopic Roux-en-Y gastric bypass.Observation indicators:(1) surgical and postoperative conditions;(2) changes in anthropometric indices;(3) follow-up.Follow-up using outpatient examination was performed to detect complications of patients at 1,3,6,12 months after surgery up to February 2013.Measurement data with normal distribution were represented as Mean±SD,repeated measurement data were analyzed using repeated ANOVA.Count data were represented as absolute numbers.Results (1) Surgical and postoperative conditions:all the patients underwent laparoscopic Roux-en-Y gastric bypass successfully,without conversion to open surgery.The volume of intraoperative blood loss,operation time,and duration of hospital stay were (25± 11) mL,(78± 14) minutes,and (11±2) days.(2) Changes in anthropometric indices:the body mass index (BMI),fat mass,free fat mass,total abdominal fat volume (TAFV),total subcutaneous fat volume (TSFV),and total visceral fat volume (TVFV) of all the 52 patients were (31.8 ± 1.8)kg/m2,(39.4±4.1)kg,(50.2±6.0)kg,(l1 703±3 899)cm3,(7 418±2 969)cm3,and (4 314± 1 692)cm3 before surgery,(28.5±1.4)kg/m2,(33.0±1.1)kg,(49.7±4.6)kg,(11 016±3 713) cm3,(7 044± 2970)cm3,(3969±1 443)cm3 at 3 months after surgery,(27.1±1.7)kg/m2,(30.2±1.3)kg,(45.4± 3.1)kg,(9 406±4 452)cm3,(6 442±3 307)cm3,and (2 964±1 694) cm3 at 6 months after surgery,(24.4± 2.4)kg/m2,(32.6±1.1)kg,(48.6±2.7)kg,(7 612±3 029)cm3,(5 623±2 650)cm3,and (1 826±360) cm3 at 12 months after surgery,respectively,there were significant differences in the changes of these indices (F=130.2,30.3,4.9,25.6,11.9,16.5,P＜0.05).The BMI,fat mass,and TAFV at 3 months after surgery had significant differences compared with those before surgery (P＜0.05),but free fat mass,TSFV,and TVFV had no significant difference (P＞0.05).The BMI,fat mass,TAFV,and TVFV at 6 months after surgery had significant differences compared with those before surgery (P ＜ 0.05),but free fat mass and TSFV had no significant difference (P＞0.05).The BMI,fat mass,TAFV,TSFV,and TVFV at 12 months after surgery had significant differences compared with those before surgery (P＜0.05),but free fat mass had no significant difference (P＞ 0.05).(3) Follow-up:all the 52 patients have completed the follow-up after surgery and the remission number of obesity was 35.No complications such as anastomotic hemorrhage,obstruction,or anastomotic leakage occured in all the 52 patients.Conclusion Laparoscopic Roux-en-Y gastric bypass can reduce abdominal visceral fat significantly,while quantitative computed tomography can help to evaluate the distribution of abdominal visceral fat accurately.
ABSTRACT
The role of PACAP (pituitary adenylate cyclase activating polypeptide), a peptidergic transmitter, in the pathogenesis of acute pancreatitis is not yet clear. This experiment was conducted to examine the action of exogenous PACAP on rat pancreas and on the course of experimental acute pancreatitis. The results showed that 5-30 microg/kg of PACAP slightly raised the serum amylase level, induced pancreatic edema (23.88% +/- 2.532%-25.86% +/- 1.974% of experiment groups versus 29.21% +/- 5.657% of control group), inflammatory cell infiltration, vacuolization of acinar cells, and occasionally fatty and parenchymal necroses. 15-30 microg/kg of PACAP aggravated cerulein-induced acute pancreatitis; the pancreatic edema became more marked (13.45% +/- 2.045%-17.66% +/- 4.652% of expreiment groups versus 21.83% +/- 3.013% of cerulein group, P<0.05), the serum amylase level became higher; and ascites, pancreatic bleeding, fatty and parenchymal necroses, and extensive vacuolization of acinar cells appeared. For sodium taurocholate-induced pancreatitis, 5-10 microg/kg of PACAP mildly attenuated the pancreatic edema, reduced the serum amylase level (1986.91 +/- 710.97-2944.33 +/- 1182.47 IU/L vs 3690.87 +/- 2277.99 IU/L, P<0.05), whereas it caused multifocal hemorrhage and prominent necrosis in pancreas. Except the cerulein-induced pancreatitis groups, other groups were found to have reduced pancreatic functional capillary density (FCD); when pancreatic edema was taken into consideration and calibrated FCD was introduced (FCD weighted against pancreatic wet/dry ratio), all groups revealed increases in pancreatic functional capillaries when compared with normal control. In conclusion, PACAP is proinflammatory in the pathogenesis of acute pancreatitis, PACAP plus cerulein can induce acute hemorrhagic/necrotizing pancreatitis, and the action of PACAP on cerulein-induced panceatitis may differ from that on sodium taurocholate-induced one. In this experiment, pancreatic FCD was underestimated due to pancreatic edema.
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Animals , Male , Rats , Amylases , Blood , Capillaries , Pathology , Ceruletide , Disease Models, Animal , Pancreas , Pancreatitis, Acute Necrotizing , Pathology , Rats, WistarABSTRACT
VE-cadherin forms VE-cadherin/catenins complex by interacting with catenins,and VE-cadherin/catenins complex is an important component of adherens junctions(AJ). During inflammation ,different kinds of factors can increase the microvascular permeability eventually by causing the disassembly of VE-cadherin/catenins complex.