Dietary and non-dietary factors associated with serum zinc in Indian women.

Women in low-income settings, common in India, are at risk of inadequate zinc intake due to poor diet quality and low consumption of flesh foods rich in zinc. The aims of this study were to assess the prevalence of zinc status of non-pregnant rural and tribal women living in central India and to identify dietary and non-dietary factors associated with the biochemical zinc status of these women. Rural and tribal non-pregnant women 18-30 years of age were selected using proportion to population sampling near Nagpur, Maharashtra, India.

Gallbladder function before and after fundoplication.

No study has reported an association between gastroesophageal reflux disease (GERD) or its therapies and gallbladder function. We compared pre- and postoperative gallbladder function in patients undergoing fundoplication to determine the following: (1) whether patients with chronic GERD have preexisting gallbladder motor dysfunction; (2) whether medical or surgical therapy alters gallbladder function; and (3) whether division of the hepatic branch of the anterior vagus nerve is detrimental to gallbladder motility. Nineteen patients with documented GERD consented to a preoperative cholecystokinin-stimulated technetium hepatobiliary (CCK-HIDA) scan to quantify the gallbladder ejection fraction (GBEF).

The efficacy of percutaneous cholecystostomy in critically ill patients.

Percutaneous cholecystostomy (PC) has been proposed as a method of biliary decompression in critically ill patients with acute cholecystitis. We evaluated the efficacy of PC in this setting. The charts of 33 critically ill patients (mean age 52, range 5-87) who underwent PC for suspected acute cholecystitis were retrospectively examined.

Peristomal pyoderma gangrenosum and inflammatory bowel disease.

Pyoderma gangrenosum (PG) is a debilitating skin disease most often associated with inflammatory bowel disease and is a reportedly rare cause of peristomal ulceration. The lesions of PG rapidly evolve from small, erythematous pustules to deep, painful, pyogenic ulcers within hours to days of onset. Although the behavior and the appearance of the lesions of peristomal PG are diagnostic, a lack of familiarity with PG often leads to misdiagnosis and inappropriate therapy.

Laparoscopic cholecystectomy: comparison of university and community experience.

We compared the first year's experience in performing laparoscopic cholecystectomy in a university hospital and a community hospital to determine the impact of postgraduate surgical training on outcome. Laparoscopic cholecystectomy was attempted on 446 patients. The conversion rate to open cholecystectomy was 8.

Leak after vertical banded gastroplasty.

We have reported the case of a morbidly obese patient who became gravely ill during the first day after vertical banded gastroplasty. The diagnosis of a leak from the stomach was established by a Gastrografin swallow, and ten additional operations were done before the patient was discharged on the 135th postoperative day.

Leaks occurring after gastric bariatric operations.

A leak from the stomach is the most serious complication that occurs after a gastric bariatric operation. The experience with 19 leaks that occurred after 791 gastric bariatric operations performed at North Carolina Memorial Hospital from 1975 to 1986 is described. The incidence of leaks was higher (8.

Cholecystectomy in morbidly obese patients.

Indications for performing cholecystectomy simultaneously with a gastric bariatric operation remain controversial. The extremes are to always perform cholecystectomy or to perform cholecystectomy only when there are palpable stones or the gallbladder is grossly diseased. Since 1975, 136 cholecystectomies have been performed simultaneously in 724 patients who had a gastric bariatric operation.

Effect of proximal transposition of the ileum on mucosal growth and enzyme activity in orally nourished rats.

To determine whether exposure to proximal intestinal contents per se is an adequate stimulus for ileal adaptation of the magnitude seen after jejunectomy, rats were prepared by transposing 30 cm of distal ileum to the duodenojejunal junction or by sham operation. One month after surgery, mucosal mass (wet weight, protein content, and DNA content) and digestive enzyme activities were measured in segments of small intestine and compared between the groups. Measurements of mucosal mass in transposed ileum more than doubled those in control jejunum (p less than 0.

The use of barium enema in the evaluation of patients with possible appendicitis.

Patients with right lower quadrant pain and possible appendicitis may present a difficult diagnostic dilemma to the surgeon. Barium enema has been used as an adjunctive test in the evaluation of patients with right lower quadrant pain in whom the diagnosis is unclear. The authors retrospectively reviewed their experience with 33 patients to determine the value of barium enema.

Complications requiring operative intervention after gastric bariatric surgery.

In a series of 565 morbidly obese patients having one of five gastric bariatric procedures done at North Carolina Memorial Hospital between May 1975 and December 1982, 55 patients had 58 complications requiring reoperation. These complications included a leak from the stomach or anastomosis, stomal obstruction, and subphrenic abscess. Weight loss after vertical banded gastroplasty appears to be comparable to that following gastric bypass with Roux-en-Y gastrojejunostomy.

Morbid obesity. Second gastric operations for poor weight loss.

This is a report of a clinical investigation of weight gain occurring after initial good weight loss following an operation performed to treat morbid obesity. The reasons for weight gain or poor weight loss after the first operation, the indications for a second operation, and the effectiveness and complications of four different "second" operations were examined. Thirty-five patients who were weight loss failures, a subgroup of 556 patients upon whom one of five bariatric operations had been performed, provided the clinical material for this investigation.

Intraoperative ultrasonography evaluation of the gallbladder in morbidly obese patients.

Intraoperative ultrasound evaluation of the gallbladder was performed in 55 morbidly obese patients undergoing gastric bariatric surgery. Cholecystectomy was performed in the presence of any physical or ultrasonographic abnormality. Eighteen patients (33%) had cholecystectomy.

Mallory-Weiss syndrome in a 10-month-old infant requiring surgery.

Mallory-Weiss syndrome is infrequent in children. Intractable hemorrhage requiring surgery has been reported in only one 6-year-old child in the English literature. We present a case of intractable hemorrhage from a Mallory-Weiss lesion in a 10-month-old infant requiring surgery.

Reversal of jejunoileal bypass.

The postoperative course of 48 morbidly obese patients upon whom a JIB operation was performed is reported. The indications for reversal of the JIB, the reversal operations and the gastric restrictive operations performed upon these patients are described. The results of this clinical investigation indicate that serious sequelae develop in most patients treated by JIB indicating reversal.

Computed tomography in recurrent or metastatic colon cancer: relation to rising serum carcinoembryonic antigen.

Twenty patients with Stage Duke B or C adenocarcinoma of the colon or rectum who have undergone radical surgical resection and demonstrated rising serum carcinoembryonic antigen (CEA) during follow-up are the subject of this study. In all cases, while there was a continuous and progressive elevation of serum CEA, CT examination of the abdomen and pelvis was performed. Abnormal CT findings were demonstrated in 19 patients and included pelvic mass, liver metastases, and periaortic or mesenteric lymphadenopathy.

Effect of removal of pancreaticobiliary secretions on adaptation to short bowel in orally nourished rats.

To evaluate the need for intraluminal pancreaticobiliary secretions for mucosal adaptation in animals with short bowel, groups of paired rats were prepared with: 1) normal bowel length, 2) 60% proximal small bowel bypass, and 3) similar bypass of distal bowel. One animal in each pair underwent operative diversion of pancreaticobiliary secretions to distal (group 1) or bypassed intestine (groups 2 and 3). Rats were fed an elemental diet and killed 1 month later.

Cholelithiasis in morbid obesity.

This study is based upon our experience with 477 morbidly obese patients who had gastric bariatric surgery during a five-year period. The incidence of biliary tract disease was 39.1%, about four times the incidence in the nonobese population.