Computerized feedback during colonoscopy training leads to improved performance: a randomized trial.

Background And Aims: Simulation-based training in colonoscopy is increasingly replacing the traditional apprenticeship method to avoid patient-related risk. Mentoring during simulation is necessary to provide feedback and to motivate, but expert supervisors are a scarce resource. We aimed to determine whether computerized feedback in simulated colonoscopy would improve performance, optimize time spent practicing, and optimize the pattern of training.

Surface and Electrochemical Studies on Silicon Diphosphide as Easy-to-Handle Anode Material for Lithium-Based Batteries-the Phosphorus Path.

The electrochemical characteristics of silicon diphosphide (SiP) as a new anode material for future lithium-ion batteries (LIBs) are evaluated. The high theoretical capacity of about 3900 mA h g (fully lithiated state: LiSi + LiP) renders silicon diphosphide as a highly promising candidate to replace graphite (372 mA h g) as the standard anode to significantly increase the specific energy density of LIBs. The proposed mechanism of SiP is divided into a conversion reaction of phosphorus species, followed by an alloying reaction forming lithium silicide phases.

Cardiac-specific succinate dehydrogenase deficiency in Barth syndrome.

Barth syndrome (BTHS) is a cardiomyopathy caused by the loss of tafazzin, a mitochondrial acyltransferase involved in the maturation of the glycerophospholipid cardiolipin. It has remained enigmatic as to why a systemic loss of cardiolipin leads to cardiomyopathy. Using a genetic ablation of tafazzin function in the BTHS mouse model, we identified severe structural changes in respiratory chain supercomplexes at a pre-onset stage of the disease.

Uth1 is a mitochondrial inner membrane protein dispensable for post-log-phase and rapamycin-induced mitophagy.

Mitochondria are turned over by an autophagic process termed mitophagy. This process is considered to remove damaged, superfluous and aged organelles. However, little is known about how defective organelles are recognized, what types of damage induce turnover, and whether an identical set of factors contributes to degradation under different conditions.

MITRAC links mitochondrial protein translocation to respiratory-chain assembly and translational regulation.

Mitochondrial respiratory-chain complexes assemble from subunits of dual genetic origin assisted by specialized assembly factors. Whereas core subunits are translated on mitochondrial ribosomes, others are imported after cytosolic translation. How imported subunits are ushered to assembly intermediates containing mitochondria-encoded subunits is unresolved.

The channel-forming Sym1 protein is transported by the TIM23 complex in a presequence-independent manner.

The majority of multispanning inner mitochondrial membrane proteins utilize internal targeting signals, which direct them to the carrier translocase (TIM22 complex), for their import. MPV17 and its Saccharomyces cerevisiae orthologue Sym1 are multispanning inner membrane proteins of unknown function with an amino-terminal presequence that suggests they may be targeted to the mitochondria. Mutations affecting MPV17 are associated with mitochondrial DNA depletion syndrome (MDDS).

[Proximal osseous integration in THR using the cementless Vektor-Titan stem: medium- and long-term results].

Objective Of The Study: The objective of this study is to establish the medium-term and long-term clinical and radiological results with the cementless Vektor-Titan stem. Special consideration has been given to evaluate the extent to which the implant design achieves proximal stress transfer, thus avoiding stress shielding in the proximal femur.

Material And Methods: From October 10, 1996, to May 18, 2000, 432 Vektor-Titan stems were implanted in 348 patients in the Wichernhaus Orthopaedic Clinic at Rummelsberg Hospital.

Mimicking a SURF1 allele reveals uncoupling of cytochrome c oxidase assembly from translational regulation in yeast.

Defects in mitochondrial energy metabolism lead to severe human disorders, mainly affecting tissues especially dependent on oxidative phosphorylation, such as muscle and brain. Leigh Syndrome describes a severe encephalomyopathy in infancy, frequently caused by mutations in SURF1. SURF1, termed Shy1 in Saccharomyces cerevisiae, is a conserved assembly factor for the terminal enzyme of the respiratory chain, cytochrome c oxidase.

Early postoperative hemorrhage after open and laparoscopic roux-en-y gastric bypass.

Background: Early postoperative hemorrhage is an infrequent complication of both laparoscopic and open Roux-en-Y gastric bypass (RYGBP). The objective of our study is to review the incidence and management of this complication and identify contributing clinical and technical risk factors.

Methods: Over a 3-year period, 1,025 patients underwent RYGBP at our institution.

Post discharge prophylactic anticoagulation in gastric bypass patient-how safe?

Background: It is becoming an increasingly common practice to discharge gastric bypass (GBP) patients on prophylactic anticoagulation. This is because pulmonary embolism (PE) is a common cause of mortality postoperatively. This study was undertaken to: (1) determine the incidence of major bleeding in GBP patients discharged on prophylactic low molecular weight heparin (LMWH)-enoxaparin and, (2) correlate the bleeding risk to the dose used.

How do family practitioners perceive surgery for the morbidly obese?

Background: Little is known about the level of knowledge and comfort with bariatric surgery among family practice physicians.

Methods: Surveys were sent to all family practitioners in Connecticut querying the practice type and knowledge of bariatric surgery. The results were analyzed for the prevalence of opinion.

Natural history of morbid obesity without surgical intervention.

Background: To study the mortality among morbidly obese patients qualifying for bariatric surgery. Mortality from bariatric surgery for morbid obesity has been widely reported; however, little is known about the mortality in morbidly obese patients who defer surgery.

Methods: Consecutive patients evaluated for bariatric surgery with an initial encounter between 1997 and 2004 were identified.

[Allergic reaction to components of bone cement after total knee arthroplasty].

There are many reports about allergic reactions in association with total hip or knee arthroplasty. While most studies focus on allergic reactions to metallic components, only few reports exist about reactions to bone cement or its ingredients. We report about a patient who developed eczema at the knee and the lower leg one year after cemented TKR.

Clinical pulmonary embolus after gastric bypass surgery.

Background: Pulmonary embolus (PE) is one of the most common causes of death for patients undergoing gastric bypass surgery. The risk of developing PE has been associated with increased age, greater body mass index (BMI), and chronic venous stasis disease.

Methods: Between 1998 and 2003, 1225 patients underwent open Roux-en-Y gastric bypass (RYGBP) surgery (258 men and 967 women) for the treatment of morbid obesity and its related disorders.

Effects of delaying appendectomy for acute appendicitis for 12 to 24 hours.

Objective: To determine whether delaying appendectomy for 12 hours to avoid disturbing the operating room schedule and to minimize the number of operations during the night negatively affects the outcome of patients with acute appendicitis.

Design: Retrospective study.

Setting: Large teaching community hospital.

Subchronic inhalation toxicity study of caprolactam (with a 4-week recovery) in the rat via whole-body exposures.

This study was designed to assess the potential subchronic inhalation toxicity of caprolactam when administered as a 3-micron aerosol from an aqueous solution to Sprague-Dawley CD rats (10/sex/group) via whole-body exposure. The study was enhanced with the inclusion of motor activity measurements and a functional observational battery to assess the neurotoxic potential of caprolactam. The rats were exposed at least 65 times over a 13-week period for 6 h per day, 5 days per week, to target concentrations (3 microns, mass median aerodynamic diameter) of 0, 25, 75, and 250 milligrams per cubic meter (mg/m3).

Abnormal intraoperative cholangiography. Treatment options and long-term follow-up.

Objective: To determine the long-term outcome in patients with filling defects on intraoperative cholangiography.

Design: Case series; retrospective review.

Setting: Community teaching hospital.

Late results of gastric bypass surgery for morbid obesity.

Objective: Morbid obesity (excess body weight of 45.5 kg or 100% over ideal body weight) is associated with > 3-fold increased mortality in men and women and is resistant to dietary intervention. Gastric bypass (GBP) and vertical banded gastroplasty (VBG) are the currently accepted surgical treatments.

Fine-needle aspiration biopsy of pancreatic ductal adenocarcinoma: loss of diagnostic accuracy with small tumors.

Eighty-three patients underwent CT-directed fine-needle aspiration biopsies (FNAB) for pancreatic ductal adenocarcinoma. Five factors that might have influenced the diagnostic sensitivity of FNAB were analyzed: clinical history, the number of passes for each FNAB, and three radiologic criteria including tumor size, tumor location, and the presence or absence of suspected tumor necrosis by CT scan. Sixty-three patients had a diagnosis of pancreatic carcinoma confirmed by FNAB (overall sensitivity = 76%).

Evidence for diminished B12 absorption after gastric bypass: oral supplementation does not prevent low plasma B12 levels in bypass patients.

Vitamin and mineral assays were performed on blood in 20 gastric bypass patients preoperatively and 6 and 12 months postoperatively. Values were compared with serial food records in nine patients. Postoperatively, all patients were prescribed a supplement containing the recommended dietary allowances (RDA) for vitamins and minerals.

Gallstone lithotripsy vs cholecystectomy. A preliminary cost-benefit analysis.

From July 1988 to January 1989, we compared the course of 48 patients undergoing elective cholecystectomy with that of 18 undergoing extracorporeal shock wave lithotripsy for symptomatic cholelithiasis with respect to treatment, hospitalization, recovery, and cost. For elective cholecystectomy, average length of surgery was 76 minutes (range, 31 to 186 minutes); average length of stay was 4 days; total cost was $6240; morbidity was 10%; and return to work averaged 5 weeks. Average extracorporeal shock wave lithotripsy treatment length was 136 minutes (80 to 158 minutes); average length of stay was 2 days; total cost was $5921; and hematuria and petechiae were seen in 33% and 28%, respectively.

Biosynthetic precursor (214 kDa) of apolipoprotein B-48 is not secreted by Caco-2 cells and normal human intestine.

The synthesis and secretion of apolipoprotein B (apo B) was studied in a human colon carcinoma (Caco-2) cell line and in explants from normal human intestine. In Caco-2 cells, the specific activity of the intestinal disaccharidases maltase, sucrase-isomaltase and lactase was enhanced 8-, 6- and 3-fold respectively, at 19 days post-confluence as compared with 1-day-post-confluence cultures. The level of apo B secreted into the medium increased from undetectable in the cells just reaching confluency, to 115 ng/ml at 18 days post-confluence.