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Biomedical subjects

M Deitel

Publications and source records attributed to M Deitel.

At least 37 records · Page 2Linked to original sources
PubMed1999

Endoscopic threaded imaging port (EndoTIP) for laparoscopy: experience with different body weights.

BACKGROUND: A laparoscopic access system was developed for primary port insertion. The cannula requires no trocar and no axial penetration force during insertion. It provides magnified visualization through the scope on the monitor during access and exit. The device has a proximal valve section and a distal cannula section with a single thread winding around its outer surface, ending in a blunt tip. After umbilical incision and Veress insufflation, a 0 degrees laparoscope is mounted in the cannula. The tip of the cannula is inserted into a tiny fascial incision and rotated clockwise. The fascia and then the muscle fibers spread radially and are transposed onto the cannula's outer thread. The thin peritoneum transilluminates; bowel, vessels, and/or adhesions are visualized before entry into the peritoneum. METHODS: The cannula was used in 234 consecutive patients: 8.1% were markedly obese, with a body mass index (BMI) > or =35, 14.8% were moderately obese (BMI 30 to <35), and 77.1% were mildly obese or normal (BMI <30). RESULTS: There were no instrument-related or insertion-related complications. No insertion failed. Insertion time was slightly longer in the morbidly obese patients who had had previous umbilical surgical incisions. No port-site hernias have been found thus far (follow-up 6-48 months). CONCLUSION: This reusable cannula was found to be safe for any body weight.

Body Mass Index↗
PubMed1999

Surgery for morbid obesity. Overview.

Obesity is a major health hazard in developed countries, and morbid obesity is associated with serious, debilitating and life-threatening sequelae. Medical treatments have been unsuccessful in the long run, if at all. Operations for massive obesity have developed over the last 40 years, based on malabsorption or gastric reduction, or a combination of both. These operations are being extended into the laparoscopic realm. Operation has been found to be the only method of achieving sustained significant weight loss, with reversal of the co-morbidities and rehabilitation, and with an acceptable complication rate, in the majority of these patients.

Biliopancreatic Diversion↗
PubMed1998

Overview of operations for morbid obesity.

Massive obesity is prevalent and associated with serious comorbidities. For patients who cannot sustain weight loss, malabsorption and gastric reduction operations have been developed. Patients with the former operation require surveillance for protein malnutrition and other sequelae; those with gastric reduction require a permanent tiny reservoir and stoma. Long-term follow-up surveillance is necessary. Postoperatively, 15% to 40% of patients, depending on the operative procedure performed, fail to maintain adequate weight loss. Successful weight loss in most of these patients makes this challenging surgery worthwhile, with alleviation of devastating disease and marked improvement in quality of life.

Humans↗
PubMed1997

Comparison of the enzyme activities between the thickest and the thinnest parts of the abdominal pannus.

OBJECTIVE: According to some reports, there are variations in metabolism in adipocytes from different areas of the body. The purpose of this study was to determine if there are differences in some of the lipid assimilating enzyme activities between the thickest (overhang) and the thinnest (upper margin) parts of the abdominal pannus. METHODS: The abdominal panniculectomy activities of sn-glycerol-3-phosphate dehydrogenase (31 subjects, spectrophotometric method), fatty acid synthetase (14 subjects, spectrophotometric method) and lipoprotein lipase (18 subjects, radioactive method) were determined in the thickest and the thinnest parts of the pannus of lipectomy patients. RESULTS: The enzyme activities were as follows: sn-glycerol-3-phosphate dehydrogenase: thickest: 2083 +/- 227.7 nm/mg/min; thinnest: 2084 +/- 208.3 nm/mg/min (p < 0.098, T = 0.02). Fatty acid synthetase: thickest: 22.0 +/- 3.9 microns/mg/min; thinnest 25.9 +/- 6.9 microns/mg/min (p < 0.36, T = 0.94). Lipoprotein lipase: thickest: 0.70 +/- 0.11% of control; thinnest: 0.61 +/- 0.14% of control (p < 0.47, T = 0.75). Thus no differences in specific enzyme activities were found between the two sites studied. CONCLUSIONS: There was no difference in the activity of the enzymes studied at the thickest and the thinnest part of the pannus.

Abdomen↗
PubMed1996

Effect of Abdominal Lipectomy on Lipid Profile, Glucose Handling and Blood Pressure in Patients with Truncal Obesity.

BACKGROUND: Previous studies have found that people with apple (android)-shaped body fat distribution are at risk of developing cardiovascular disease, impaired glucose tolerance and hypertension. METHODS: To investigate the effects of lipectomy, we measured lipid and lipoprotein levels, indices associated with glucose tolerance and blood-pressure. The tests were performed pre-operatively and 3 and 12 months post-operatively in 34 subjects (obese lipectomy patients with android-shaped body fat distribution) and 23 controls (obese breast reduction patients). RESULTS: In subjects, total cholesterol, LDL and blood pressure were significantly lower at 3 months follow-up, but returned to pre-operative levels at 12 months follow-up. Plasma insulin decreased significantly at 3 months follow-up, and continued to decrease at 12 months follow-up. Triglycerides, HDL, fasting blood sugar, glycosylated hemoglobin and C-peptide did not change at 3 and 12 months follow-up. There were no changes in controls. CONCLUSIONS: Lipectomy in patients with truncal obesity may reduce plasma insulin levels, but had no lasting effect on plasma lipids.

Journal Article↗
PubMed1996

Increasing vimentin expression associated with differentiation of human and rat preadipocytes.

Alterations in the cytoskeletal apparatus constitute some of the earliest changes during assumption of an adipogenic phenotype. We examined three major cytoskeletal elements, beta-actin, alpha-tubulin and vimentin, during adipogenesis in euploid cells from human and rat adipose tissue. As reported with 3T3 sub-lines, mRNA level for beta-actin and alpha-tubulin were decreased upon differentiation. However, in contrast to reports with 3T3 cells, levels of vimentin were increased during differentiation. Furthermore, immunological analyses confirmed that there was no decrease in vimentin protein levels during adipogenic development. As well as highlighting a difference between 3T3 cell lines and preadipocytes isolated from fat depots, these studies indicate that the pattern of cytoskeletal gene expression undergoes complex changes early during preadipocyte differentiation.

Actins↗
PubMed1995

Increased obese mRNA expression in omental fat cells from massively obese humans.

Obesity presents a significant challenge to the general health of affluent nations in terms of the number of people affected, the serious associated maladies and the lack of effective treatments. While common wisdom has held that obesity results from 'gluttony and sloth', a number of studies have indicated physiological causes of underlying the pathogenesis of obesity, with the degree of adiposity having a strong genetic component. Recently, the obese gene in the ob/ob mouse was cloned, along with its human homologue. The specific production of the obese protein by adipose tissue suggested that it may function in a feedback loop from fat tissue to the hypothalamus to control energy intake and/or energy expenditure, and that it may play a role in the pathogenesis of human obesity. In this study we report that obese mRNA expression is elevated in ex vivo omental adipocytes isolated from massively obese humans in the absence of an identifiable mutation. Therefore, we speculate that this increased expression may suggest that the massively obese are insensitive to the putative regulatory function(s) of the obese gene product.

Adipose Tissue↗