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Biomedical subjects

N Scopinaro

Publications and source records attributed to N Scopinaro.

At least 91 records · Page 5Linked to original sources
PubMed1981

Gut hormone changes after jejunoileal (JIB) or biliopancreatic (BPB) bypass surgery for morbid obesity.

The treatment of obesity by intestinal bypass provides a unique model for the investigation of gut hormone release from the functionally deranged bowel. We have examined the postprandial response of eight circulating gut or pancreatic peptide hormones in 16 preoperative obese patients, 20 patients with jejunoileal bypass, 38 patients with biliopancreatic bypass and 13 age and sex-matched controls. Basal and post-meal hormone concentrations were determined by specific radioimmunoassay methods. Reductions of the upper small intestinal hormones, motilin and gastric inhibitory polypeptide were found in both types of surgery. Conversely, the ileal hormones neurotensin and enteroglucagon were elevated following surgery. This pattern is consistent with the known distribution of these hormones. Variations of response due to surgical differences were noted for gastrin and the enteropancreatic axis, which was more markedly disturbed after biliopancreatic bypass. The alterations of hormone release closely reflect the anatomical changes induced by each particular surgical technique.

Adult↗
PubMed1981

Hyperoxaluria associated with intestinal bypass surgery for morbid obesity: occurrence, pathogenesis and approaches to treatment.

Hyperoxaluria occurs in most patients after the conventional jejunoileal bypass procedure for obesity. The mechanism of hyperoxaluria is complex, involving persistence of dietary oxalate in solution as well as increased colonic permeability to oxalate. Endogenous oxalate formation also contributes to hyperoxaluria. Treatment is unsatisfactory and involves a low-oxalate diet and simultaneous administration of agents which bind oxalate and bile acids, such as aluminum hydroxide. Hyperoxaluria was not present in 21 of 22 patients who had undergone the pancreato-biliary bypass procedure.

Biliary Tract Surgical Procedures↗
PubMed1980

[Behavior of plasma insulin and GIP in obese patients subjected to biliopancreatic bypass].

Biliopancreatic bypass for obesity entails a 2/3 distal gastrectomy with Roux-en-Y reconstruction, being the small bowel transected at its midpoint and the enteroenteroanastomosis placed 50 cm proximal to the ileocecal valve. Insulin and GIP fasting and meal-stimulated plasma concentrations were determined in 13 nonobese healthy volunteers, in 13 nonoperated obese patients, in 11 subjects within two months, in 12 subjects four to twelve months, and in 7 subjects fifteen to twenty months after operation. Insulin in the obese patients was significantly higher than in the control group. Postoperatively these patients showed a sharp reduction in basal and postprandial values. Plasma insulin levels, both basally and following the test meal, were very similar in the 15-20 month and the control group. Plasma GIP fasting level, meal-stimulated peak and integrated response in the obese group were higher than in control group. Due to the extreme variability among subjects in the obese group, the difference was significant only for the mean peak response. All values were greatly reduced after surgery. The mean fasting level in the 15-20 month group was very similar to that in the control group, and both peak and integrated responses were significantly lower than in the preoperative and control groups.

Fasting↗
PubMed1980

[Behavior of plasma enteroglucagon and neurotensin in obese patients subjected to biliopancreatic bypass].

Biliopancreatic bypass for obesity entails a 2/3 distal gastrectomy with Roux-en-Y reconstruction, being the small bowel transected at its midpoint and the enteroenteroanastomosis place 50 cm proximal to the ileocecal valve. Neurotensin and enteroglucagon fasting and meal-stimulated plasma concentrations were determined in 13 nonobese healthy volunteers, in 13 nonoperated obese patients, in 11 subjects within two months, in 12 subjects four to twelve months and in 7 subjects fifteen to twenty months after operation. Basal plasma enteroglucagon was significantly higher in the obese group than in the controls. However, there was no difference in the peak response, and a decrease, though not statistically significant, was seen in the integrated response. All three values were strikingly augmented in the 0-2 month group, with a highly significant difference from the preoperative group. The 4-12 and 15-20 month groups, in comparison with the 0-2 month group, showed no changes in fasting levels, a clear-cut decreased peak response and a sharp progressive reduction in integrated response, mean value in the 15-20 month group being significantly lower than that of 0-2 month group. Neurotensin basal and meal-stimulated peak plasma concentrations in the obese group were significantly higher than in the control group, whilst the integrated response was almost identical in the two groups. In postoperative groups no substantial changes in fasting levels and an increase in the peak response were observed, with a considerable progressive rise in the integrated response.

Fasting↗
PubMed1980

[Behavior of plasma pancreatic polypeptides and motilin in obese patients subjected to biliopancreatic bypass].

Biliopancreatic bypass for obesity entails a 2/3 distal gastrectomy with Roux-en-y reconstruction, being the small bowel transected at its midpoint and the enteroenteroanastomosis placed 50 cm proximal to the ileocecal value. Pancreatic polypeptide (PP) and motilin fasting and meal-stimulated plasma concentrations were determined in 13 nonobese healthy volunteers, in 13 nonoperated obese patients, in 9 subjects within two months, in 12 subjects four to twelve months, and in 7 subjects fifteen to twenty months after operation. There were no significant differences in PP fasting levels between either the obese and control groups or between the postoperative groups and the preoperative group. Both meal-stimulated peak and integrated response values were similar in the obese and control groups, and were strikingly and progressively reduced postoperatively, with statistically significant difference between all postoperative groups and preoperative group. Mean plasma motilin fasting and peak values were higher in the obese group than in the control group, and significantly reduced in the 4-12 and 15-20 month group. Despite the huge variability among data, the integrated response in the 0-2 month group was significantly decreased in comparison with the preoperative group, while a subsequent progressive increase was shown by the 4-12 and 15-20 month groups.

Fasting↗
PubMed1980

[Behavior of plasma gastrin in obese subjects subjected to biliopancreatic bypass].

Biliopancreatic bypass for obesity entails a 2/3 distal gastrectomy with Roux-en-Y reconstruction, small bowel being transected at its midpoint and the enteroenterostomy placed 50 cm proximal to the ileocecal valve. Plasma fasting and meal-stimulated gastrin concentrations were measured by radioimmunoassay in 13 nonobese healthy volunteers, 13 pre-surgery obese patients, 11 patients within two months, 12 patients between four and twelve months and 7 patients between fifteen and twenty months after operation. There were no significant differences in fasting and meal-stimulated peak plasma gastrin levels between obese group and the control group and between any of the postoperative groups and the preoperative group. The 15-20 month post-surgery group mean fasting value was lower than in the other groups, whilst the mean peak value was unchanged. Integrated gastrin response was significantly higher in this group than in the preoperative group.

Biliary Tract Surgical Procedures↗
PubMed1979

Bilio-pancreatic bypass for obesity: 1. An experimental study in dogs.

Bilio-pancreatic bypass is a new procedure that tries to obtain a maldigestion syndrome with selective malabsorption of the main high calorie foods. The operation consists of a gastric resection and division of the proximal jejunum just distal to the ligament of Treitz. A gastroentero-anastomosis is then constructed using the distal end of the transected jejunum, while the proximal jejunum is anastomosed to the side of the distal ileum. An experimental study carried out on 12 dogs confirmed that the operation causes a selective malabsorption with loss of weight and no complications. On the basis of this study it is suggested that this procedure has the following advantages over jejuno-ileal bypass: (a) normal absorption of bile salts, water and electrolytes; (b) slow recovery of absorption; (c) absence of a blind loop.

Animals↗
PubMed1979

Bilio-pancreatic bypass for obesity: II. Initial experience in man.

After a successful trial of bilio-pancreatic bypass in dogs, a clinical study has been completed in 18 patients followed for more than 1 year. The operation has been modified to achieve the best weight reduction, and forming the bilio-pancreatic tract of equal length to the alimentary tract with a short common ileal tract, the average weight loss as a percentage of the preoperative body weight was 24.1 +/- 5.4 per cent (mean +/- s.d.) at 6 months and 33.7 +/- 4.1 per cent at 12 months. The only immediate complication was a wound dehiscence, and there were no late complications. Liver function studies showed the absence of hepatic deterioration and liver biopsies showed improvement of liver morphology 1 year after the operation. It is suggested that this procedure may be an alternative to jejuno-ileal bypass in the management of obesity.

Adolescent↗
PubMed1978

[Behavior of the serum electrolytes after jejuno-ileal bypass for obesity].

Serum electrolytes, diarrhoea and absorption of bile salts were examined before and for one year after jejuno-ileal by-pass in 5 obese subjects. Marked decrease in blood potassium, calcium and magnesium was noted post-operatively, with potassium and calcium levels still well below the preoperative levels after 1 yr. Faecal volume increased considerably soon after operation, then fell to about 1 1/day in the first few months and changed little thereafter. Absorption of bile salts was seriously and lastingly compromised. In the light of the relevant literature, these results show that electrolyte imbalance, being closely linked to diarrhoea induced by bile salts, is an inevitable consequence of this operation and cannot be controlled by changing the surgical procedure.

Adult↗