Estimating Triglyceride Levels Using Total Cholesterol, Low-Density Lipoprotein Cholesterol, and High-Density Lipoprotein Cholesterol Levels: A Cross-Sectional Study.

Objective: Triglyceride (TG) levels are affected by food intake, and the cutoff values for nonfasting TG levels vary. This study aimed to calculate fasting TG levels based on total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) levels. Methods: Multiple regression analysis was performed to determine estimated triglyceride (eTG) levels using data from 39,971 participants divided into six groups based on non-high-density lipoprotein cholesterol (nHDL-C) levels (<100, <130, <160, <190, <220, and ≥220 mg/dL). Results: Provided that fasting TG and eTG levels ≥150 mg/dL were positive and those <150 mg/dL were negative, the three groups (nHDL-C levels <100, <130, and <160 mg/dL) consisting of 28,616 participants had a false-positive rate of <5%. The coefficient and constant terms in the formula for the eTG in groups with nHDL-C levels <100, <130, and <160 mg/dL were as follows: constant terms, 12.193, 0.741, and -7.157; coefficients of LDL-C, -3.999, -4.409, and -5.145; coefficients of HDL-C, -3.869, -4.555, and -5.215; and coefficients of TC, 3.984, 4.547, and 5.231, respectively. The adjusted coefficients of determination were 0.547, 0.593, and 0.678, respectively (P < 0.001, P < 0.001, and P < 0.001, respectively). Conclusion: Fasting TG levels can be calculated from TC, LDL-C, and HDL-C levels when nHDL-C levels are <160 mg/dL. Using nonfasting TG and eTG levels as indicators of hypertriglyceridemia might eliminate the need for venous sampling after overnight fasting.

Estimation of visceral fat area using criteria for metabolic syndrome: A cross-sectional study.

BACKGROUND AND AIMS: The aim of this study was to calculate the visceral fat area (VFA) based on the criteria for metabolic syndrome (MetS). METHODS: A multiple regression analysis was performed to determine the estimated VFA using data from Japanese participants (2315 men and 1684 women). Receiver operating characteristic curve (ROC) analyses were performed to determine the optimal estimated VFA cutoff for the diagnosis of central obesity. The cutoff was also applied to a second cohort to validate the model. RESULTS: The estimated VFA was calculated using the MetS criteria, age, and body mass index (adjusted coefficient of determination = 0.682 for men and 0.726 for women). The area under the ROC curve for waist circumference, VFA, and estimated VFA were 0.669, 0.741, and 0.749, respectively, for men and 0.711, 0.787, and 0.803, respectively, for women. The optimal cutoffs for estimated VFA were 128.1 cm2 for men and 82.2 cm2 for women. Multivariate logistic regression for heart disease revealed that estimated VFA, rather than waist circumference, was associated with a high risk of heart disease. CONCLUSION: The estimated VFA is a better index of central obesity than waist circumference and VFA for the diagnosis of MetS.

Closure of duodenocutaneous fistula due to recurrent colon cancer with a pedicled jejunal seromuscular flap.

A new approach to closing a malignant enterocutaneous fistula is reported. Transverse colon cancer recurred around the superior mesenteric vein along with a duodenocutaneous fistula, thus causing severe dermatitis. The tumor was partially resected at the fascia level and the fistula measured 2.5 cm in diameter. A left rectus abdominis musculocutaneous flap failed to close the fistula because of graft necrosis. A jejunal flap measuring 8 cm in length was prepared by sacrificing about 15 cm of adjacent jejunum to create the pedicle. The mucosal layer of the flap was removed and the fistula was closed, then the tumor surface was covered. Two weeks later, the skin defect was covered with free skin grafting. The patient died of cancer 6 months after surgery, but there was no recurrence of the fistula.

Continuous vertical hemimattress suture for biliary-enteric anastomosis.

The continuous hemivertical mattress suture technique for biliary-enteric anastomosis has not been well reported in the literature. We used the technique with a double-armed monofilament absorbable suture (Glycomer 631) for 32 anastomoses in 31 patients. There was one anastomotic leakage (3.1%). The mean follow-up period was 683 days, during which time no patient developed anastomotic stenosis or cholangitis. The technique provided satisfactory results with lower cost than one-layer interrupted sutures.

Pedicled ileal flap to repair large duodenal defect after right hemicolectomy for right colon cancer invading the duodenum.

Although right-sided colon cancer occasionally invades the second part of the duodenum, there is no standard procedure for reconstructing a large duodenal defect after resection. This report describes a new approach we recently devised. After resecting the right hemicolon and the involved duodenum, a segment of terminal ileum was isolated on the vascular pedicle, sacrificing the adjacent ileum. We created a flap by opening the segment along the antimesenteric border, and used this flap to cover the defect. This method does not create a nonanatomical bypass and fewer intestinal anastomoses are required than for Roux-en-Y reconstruction.

Continuous mattress suture for all hand-sewn anastomoses of the gastrointestinal tract.

BACKGROUND: The continuous vertical mattress technique for anastomoses in the gastrointestinal or colorectal surgery has not been well reported in literature. METHODS: We used the technique for all hand-sewn anastomoses with double-armed monofilament absorbable suture (Glycomer 631). RESULTS: In the 266 consecutive anastomoses in 242 cases, there were 4 anastomotic leakages (1.5%) and 1 anastomotic stenosis (0.4%). CONCLUSIONS: The technique was feasible, time-saving, economical and with satisfactory results.