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Biomedical subjects

H Buchwald

Publications and source records attributed to H Buchwald.

At least 145 records · Page 8Linked to original sources
PubMed1977

Small bowel length in hyperlipidemia and massive obesity.

Small bowel length has been measured during intestinal bypass surgery in 272 morbidly obese patients undergoing jejunoileal bypass and 121 nonobese patients undergoing partial ileal bypass for hyperlipidemia. There was no statistically significant difference in small bowel length between the obese and the nonobese patients. Small bowel length was not correlated with the degree of obesity expressed as the percentage of ideal weight. The only statistically significant correlation determined was between sex and bowel length in the obese subjects, where a greater length of small intestine was found in the males.

Adult↗
PubMed1976

Treatment of heterozygous type II hyperlipidemia by partial ileal bypass in a pediatric population.

Nine patients underwent partial ileal bypass as management for heterozygous type II hyperlipidemia. The average age of this group was 12.5 yr. Follow-up has ranged from 1 to 6 yr. The growth and development of these children proceeded normally. The overall average serum cholesterol reduction was 33% when compared to the preoperative but postdietary control value. Side effects of the procedure include transient diarrhea and inability to absorb vitamin B12, requiring periodic parenteral administration. Partial ileal bypass has been shown to be an effective and obligatory method of treatment of hypercholesterolemia in children.

Adolescent↗
PubMed1976

Hepatic lesions of central pericellular fibrosis in morbid obesity, and after jejunoileal bypass.

Histologic findings in liver biopsy specimens obtained from 88 patients before and one and two years after end-to-end jejunoileal bypass are compared. In addition to the expected fatty changes, mild changes of centrilobular, pericellular fibrosis were present in the initial biopsies in 8.6%; a year later they had become apparent in 46%. Portal-central bridging developed in 6.8%, and early micronodular cirrhosis in 3.4%--always in those with central pericellular fibrosis. Electron-microscopic study of pre-bypass liver biopsies from eight addtional patients showed collagen and electron-dense material resembling basement membranes within the spaces of Disse in seven, although only four had light-microscopic evidence of minimal central pericellular fibrosis. The existence of these light- and electron- microscopic changes before jejunoileal bypass suggests that there is a lesion in morbid obesity that may be exacerbated during the first year after operation.

Fatty Acids↗
PubMed1976

The effect of portacaval shunt on plasma lipids and tissue cholesterol synthesis in the dog.

Portacaval shunt (PCS) has been proposed as a therapy for hyperlipidemia; however, its lipid-lowering mechanism is unknown. In this study PCS was performed on ten mongrel dogs to measure its effect on plasma lipids and on the cholesterol synthesizing ability of the liver and intestines, the major indodenous cholesterol synthesizing tissues. Plasma was analyzed for total cholesterol (CHOL), triglycerides (TG), and the CHOL content of three plasma lipoprotein fractions. Jejunal, ileal, and hepatic cholesterol synthetic rates were determined by 14C-acetate incorporation to CHOL in tissue slices obtained at operation before PCS and 44 +/- 4.1 (S.D.) days after PCS. Plasma CHOL decreased by 18 +/- 7 (S.E.), 34 +/- 8 (S.E.), and 57 +/- 14 (S.E.) mg. per 100 ml. by 4, 6, and 16 weeks after PCS, respectively. TG decreased by 13 +/- 5 (S.E.), 27 +/- 5 (S.E.), and 30 +/- 9 (S.E.) mg. per 100 ml. at corresponding time intervals. Paired Student's test analysis of CHOL and TG changes are significant at the p less than 0.05 level. CHOL content of the three plasma lipoprotein fractions decreased correspondingly. Intestinal tissue CHOL synthesis rates changed only slightly. Hepatic synthetic rates increased by 30 to 40%; however, no synthetic rate changes were statistically significant at the p less than 0.05 level. PCS is associated with decreased in plasma CHOL [42% (see article)] AND TG [53% (see article)] in dogs up to 16 weeks following operation. Statistically significant changes in endogenous CHOL synthesis were not demonstrated by this study. The mechanism by which PCS affects plasma lipids in the dog is unknown as yet.

Animals↗
PubMed1975

Gastric secretion and serum gastrin in human small bowel bypass.

Jejunolieal bypass (JIB) patients provide a unique opportunity to study the relationship between small bowel loss and gastric secretory function. Preoperatively, and approximately one year postoperatively, measurements of gastric secretion were taken in 37 patients who underwent JIB for massive obesity. Basal acid output increased by 0.52 plus or minus 0.35 mEq/hr (P greater than.2), and peak stimulated acid output increased by 1.99 plus or minus 0.96 mEq/30 min (P smaller than .05). A separate group of 26 postoperative and 17 preoperative (control) JIB patients had fasting serum gastrin levels measured by radioimmunoassay. Postoperative patients had levels of 37 plus or minus 5 pg/ml, and control patients had levels of 36 plus or minus 4 pg/ml (P greater than .5). We conclude that following JIB for obesity, there is no significant change in basal acid secretion or in serum gastrin. There is a small, but statistically significant, increase in peak stimulated acid output. We currently find no clinical correlation with this change.

Fasting↗
PubMed1975

The partial ileal bypass operation in treatment of the hyperlipidemias.

Partial ileal bypass is, today, the single most effective means available for lowering the plasma lipids, in particular the plasma cholesterol concentration. The cholesterol lowering effect of this procedure is universally lasting; response escape or rebound of lipid levels has not occurred. The operation is safe. In addition, the obligatory benefits of this mode of therapy make it attractive as a therapeutic alternative, especially in a young and asymptomatic population. We do not advocate this operation as the treatment of choice for all hyperlipidemic individuals. It may be the treatment of choice for certain patients with hyperlipidemia.

Cholesterol↗