A Comparative, Prospective and Randomized Evaluation of Roux-en-Y Gastric Bypass With and Without the Silastic Ring: A 2-Year Follow Up Preliminary Report on Weight Loss and Quality of Life.

BACKGROUND: Currently, Roux-en-Y gastric bypass (RYGB) is one of the most widely used bariatric surgeries. Banding the pouch forms a banded gastric bypass operation, an accepted and frequently used variant. Placing a silastic ring around the pouch to band the gastric bypass operation increases the restriction mechanism. However, the ubiquitous use of the banded gastric bypass remains controversial. One of the controversies is the effect of the silastic ring on patients' perception of their well being after surgery because of the frequency of vomiting. A prospective, blindly randomized, comparative trial was undertaken to resolve this controversy. METHOD: Four hundred subjects scheduled for gastric bypass surgery were randomized into two arms of the trial, 200 with a silastic ring (WR) and 200 without (NR). After 2-year follow-up, the variables associated with the scores of Bariatric Analysis and Reporting Outcome System (BAROS) were analyzed. RESULTS: The initial median weight (125 kg), BMI (47), and age (36 years) were the same in both the NR and WR groups. The median excess weight loss, weight regain, and incidence of vomiting were 71, 10.5, and 7.75%, respectively, in the NR group vs. 75.4 and 1.1, and 24.4% in the WR group. The mean QOL score was 79% in the NR group vs. 80% in the WR group. CONCLUSION: After 2-year follow-up, silastic ring placement in the RYGB resulted in greater weight loss and weight stability and a threefold greater incidence of vomiting. There was no difference in the scores in the quality of life analysis.

Application of 252Cf-PDMS to characterize airborne particles deposited in an Antarctic glacier.

The aim of this study is to apply the (252)Cf-PDMS (plasma desorption mass spectrometry) technique to characterize particles deposited in ice samples. This technique allows identification of molecular ions, even large molecules, desorbed from the sample surface, in contrast with PIXE (particle induced X-ray emission) or EDS (energy dispersive spectrometry). Two shallow snow cores obtained from different glacial drainage basins on King George Island ice cap, South Shetland Islands (Antarctica), were analyzed by PDMS. The chemical compounds identified in the ice mass spectra show that the particle contents of both samples were statistically different, indicating a non-homogeneous spatial deposition distribution for the deposited particles. The analysis of the ice mass spectra suggests some possible sources for the airborne particles. The mass spectra of ice samples collected at a site exposed directly to air masses coming from the Drake Passage show a significant contribution of particles from crustal and anthropogenic sources. However, the mass spectra of ice samples taken from a site on a slope towards a local inlet point out a high influence of marine aerosol. Therefore, it was concluded that particles deposited onto the ice cap were attributable to different aerosol sources, besides long-range atmospheric transport. The (252)Cf-PDMS technique can be considered a powerful tool for studies of snow and ice samples, providing important information for understanding the global atmospheric transport and deposition of airborne particles.

An evaluation by rat colon anastomosis of the efficacy of fibrin glue derived from snake venom

The objective of this study was to evaluate the efficacy of fibrin adhesive made up of snake venom and bubaline fibrinogen by rat colon anastomosis. Eighty rats were randomly assigned into 2 experimental groups: GI control (anastomosis with extramucous interrupted suture) and GII (repair suture + fibrin glue). The animals were studied at the following 4 times: T0 - preoperative - T1 - 7th day postoperative, T2 - 14th day postoperative, and T3 - 21th day postoperative. The macroscopic characteristics of the intestinal segment open and closed anastomosis and the bursting strength of the anastomosed segments were observed at each of the above times. The results showed that the anastomosed segments coapted and there was no difference in the bursting strength values between the 2 groups. There was a decrease in the bursting strength values up until de 7th day postoperative in both groups with its progressive increase at the other times. Although important experimental studies using large animals are needed for a better evaluation of tissue repair processes, this adhesive may become a valuable tool for use in anastomosis.

Biological differences between reflux stimulated proliferative stomal lesions and N-methyl-N'-nitro-N-nitrosoguanidine induced carcinomas in Wistar rats.

The morphology and evolution of epithelial lesions that developed at a gastrojejunal stoma due to reflux of duodenal contents were compared with MNNG-induced carcinomas in the pyloric mucosa of rats in a long term experiment. Random bred male Wistar rats were given MNNG in drinking water (100 mg/l) for 12 weeks and then one group was submitted to a gastrojejunal anastomosis at the greater curvature in the oxyntic mucosa. Untreated rats underwent either gastrojejunostomy or gastrotomy. The animals were killed at the 24th and 66th weeks of the experiment. The lesions obtained in the pyloric mucosa and in the mucosa of the gastrojejunal stoma were analyzed histologically using hematoxylin and eosin staining and immunohistochemistry for pepsinogen isoenzyme 1. Duodenal reflux induced proliferative lesions at the gastrojejunal junction that increased in incidence and size with time. Histologically they consisted of benign epithelial proliferation of gastric type. No evidence of malignant transformation within the gastric components of the proliferative lesions at the gastrojejunal stoma was observed even at the 66th week. Adenocarcinomas induced by MNNG in the pyloric mucosa increased in size during the experiment and were morphologically and histochemically distinct from the proliferative lesions at the gastrojejunal junction. In conclusion, proliferative lesions at the gastrojejunal stoma stimulated by duodenal reflux are biologically distinct from adenocarcinomas induced by MNNG in the pyloric mucosa. They do not seem to be precursor lesions of gastric carcinogenesis, as they do not undergo malignant transformation even after long-term, up to 66 weeks, follow-up.

[Sodium diclofenac effect, after interruption of the stercoraceous peritonitis, on the rat colon. Study of mechanical resistance and collagen concentration]. / Ação do diclofenaco de sódio, após a interrupção da peritonite estercorácea, no cólon de ratos. Estudo da resistência mecânica e do colágeno tecidual.

UNLABELLED: The objective of the present study was to investigate changes in colon wall in rats with fecal peritonitis (Per) associated with sodium diclofenac (SD) by studying breaking strength and tissue collagen concentration. The rats were divided into the following experimental groups: GROUP 1-SD: 60 animals injected intramuscularly with sodium diclofenac at the dose of 2 mg/kg body weight; GROUP 2-Per: 60 animals injected intraperitoneally with a suspension of human feces. Peritonitis was interrupted after six hours of evolution; GROUP 3-Per+SD: 60 animals injected intraperitoneally with a suspension of human feces and receiving SD according to the schedule used for Groups 1 and 2; CONTROL GROUP: 12 animals injected intramuscularly with physiological saline. The animals of Group 1, 2 and 3 were successively sacrificed 2, 4, 7, 14 and 21 days after interruption of peritonitis an/or the beginning of treatment. Under conditions of the experimental model and of the methods used, we conclude that sodium diclofenac, peritonitis and the peritonitis-sodium diclofenac association decrease the breaking strength and the concentration of tissue collagen in the colon segment.

[Influence of proximal gastric vagotomy on the esophageal high pressure zone in dogs]. / Influência da vagotomia gástrica proximal sobre a zona de alta pressão esofagogástrica do cão.

The influence of parietal cell vagotomy (PCV) on esophagogastric high pressure zone (HPZ) (pressure and length) was studied in 30 dogs. The animals were divided in 3 groups: group 1, 10 dogs submitted to PCV with gastric denervation until the esophagogastric junction; group 2, 10 dogs submitted to PCV with gastric denervation into esophagogastric junction and 3 cm above this; group 3 (control), 10 dogs submitted to laparotomy only. In the postoperative period (immediate and later) it wasn't observed any alteration of pressure and length of esophagogastric HPZ in three studied groups.

Colecistite cronica calculosa associada a situs inversus totalis. / Chronic calculous cholecystitis associated with situs inversus totalis

E apresentado um caso de colecistite cronica calculosa em paciente de 53 anos portadora de "situs inversus totalis". Apos exploracao radiologica e sonografica a paciente foi submetida a tratamento cirurgico com remissao total de sintomatologia.Em que pese tratar-se de patologia rara a possibilidade desse diagnostico deve ser lembrada, sendo este o objetivo da presente comunicacao