Expression and function of intestinal hexose transporters after small intestinal denervation.

Background: The role of neural regulation in expression and function of intestinal hexose transporters is unknown. The aim of this study is to determine the role of intestinal innervation in gene expression and function of the membrane hexose transporters, SGLT1, GLUT2, and GLUT5 in the enterocyte. We hypothesize that denervation of the small intestine decreases expression of hexose transporters, which leads to decreased glucose absorption.

Hexose transporter expression and function in mouse small intestine: role of diurnal rhythm.

Background: Expression and function of hexose transporters vary diurnally in rat small intestine; however, this subject remains unexplored in mice.

Aim: The aim of the study was to investigate the diurnal expression and function of hexose transporters SGLT1, GLUT2, and GLUT5 in mouse small bowel.

Methods: Twenty-four c57bl6 mice maintained in a 12-h light/dark room (6 AM: -6 PM: ) were sacrificed at 9 AM: , 3 PM: , 9 PM: , and 3 AM: (n = 6 each).

Combined transabdominal gastroplasty and fundoplication for shortened esophagus: impact on reflux-related and overall quality of life.

Background: Transabdominal gastroplasty for shortened esophagus at the time of fundoplication results in a segment of aperistaltic, acid-secreting neoesophagus above the fundoplication. We hypothesized that transabdominal gastroplasty impairs quality of life (QOL).

Methods: This was a matched paired analysis with retrospective chart review and follow-up questionnaire of 116 patients undergoing transabdominal fundoplication with gastroplasty with 116 matched controls undergoing transabdominal fundoplication alone from January 1997 to June 2005.

Coordinated, diurnal hexose transporter expression in rat small bowel: implications for small bowel resection.

Background: Hexose transporter mRNA and protein levels follow a diurnal rhythm in rat jejunum. Their coordinated expression and resultant function throughout the small bowel is not well understood. We hypothesized that hexose transporter levels and glucose absorption follow a coordinated, site-specific diurnal rhythm in rat duodenum and jejunum, but not in ileum.

Effect of Roux-en-Y gastric bypass in obese patients with Barrett's esophagus: attempts to eliminate duodenogastric reflux.

Background: To assess the effect of Roux-en-Y gastric bypass (RYGB) at a tertiary referral Center of Excellence for bariatric surgery on the length and presence of dysplasia in morbidly obese patients with Barrett's esophagus (BE). Esophageal reflux of gastroduodenal contents (acid, bile) contributes to the development of BE and progression in the dysplasia-carcinoma sequence. Obese patients have a high prevalence of gastroesophageal reflux and might be at an increased risk of developing BE and esophageal adenocarcinoma.

Pancreaticobiliary and duodenal perforations after periampullary endoscopic procedures: diagnosis and management.

Objective: To review our experience with management of pancreaticobiliary and duodenal (PB/D) perforations after periampullary endoscopic interventions. Although pancreaticobiliary and duodenal perforations after periampullary endoscopic procedures are rare, their management has not been well described.

Patients: Individuals who experienced pancreaticobiliary and duodenal perforations.

Development of a simple model of extrinsic denervation of the small bowel in mouse.

Small bowel transplantation (SBT) is associated with poorly understood enteric dysfunction. The study of SBT in mice is hindered by the technical difficulty of orthotopic SBT in the mouse. Our aim was to develop an easy preparation of extrinsic denervation of the entire jejunoileum in mice as a model of orthotopic SBT.

The influence of transabdominal gastroplasty: early outcomes of hiatal hernia repair.

Objective: The aim of our study was to review our experience with transabdominal gastroplasty to determine the safety and short-term efficacy of the procedure.

Methods: Retrospective review of all patients that underwent transabdominal hiatal hernia repair with concurrent gastroplasty for shortened esophagus between October 1999 and May 2004.

Results: There were 63 patients, 27 men and 36 women.

A two-decade spectrum of revisional bariatric surgery at a tertiary referral center.

Background: Ineffective weight loss or complications of previous bariatric surgery often require revisional bariatric procedures. Our aim was to define the indications, operative approach, and outcomes of revisional bariatric procedures during 2 decades at a tertiary center.

Methods: From our prospective database (n = 1584), including 1985-2004, 218 patients (14%) underwent revisional bariatric procedures.

The malabsorptive very, very long limb Roux-en-Y gastric bypass for super obesity: results in 257 patients.

Background: For the past 11 years, we have used a malabsorptive form of Roux-en-Y gastric bypass (RYGB), the "very, very long limb" RYGB, for selected patients with BMIs >50 kg/m(2) and in highly selected patients with BMI <50 kg/m(2). This modified distal gastric bypass establishes a 100-cm common channel (for digestion and absorption) and a "very, very" long Roux limb of 400 to 500 cm.

Methods: To determine long-term efficacy and complications, we followed prospectively 257 consecutive patients; 188 (73%) participated in a postoperative survey.

Enteric hyperoxaluria, nephrolithiasis, and oxalate nephropathy: potentially serious and unappreciated complications of Roux-en-Y gastric bypass.

Background: Neither the presence nor prevalence of enteric hyperoxaluria has been recognized after Roux-en-Y gastric bypass (RYGBP). We have noted a high rate of oxalate nephrolithiasis and even 2 patients with oxalate nephropathy in this patient population postoperatively. Our aim was to determine the frequency of the occurrence and effects of enteric hyperoxaluria after RYGBP.

Is Roux-en-Y gastric bypass safe after previous antireflux surgery? Technical feasibility and postoperative symptom assessment.

Background: Clinically significant morbid obesity is associated with an increased risk of gastroesophageal reflux disease. Vertical Roux-en-Y gastric bypass (RYGBP) is known to eliminate acid (and bile) in the pouch of cardia, which would provide control of reflux symptoms. The aim of our study was to assess the technical considerations, morbidity, and safety of RYGBP after previous antireflux surgery and evaluate postoperative reflux symptoms.

Postprandial augmentation of absorption of water and electrolytes in jejunum is neurally modulated: implications for segmental small bowel transplantation.

Postprandial augmentation of absorption of water and electrolytes is believed to occur in the jejunum. Neural mechanisms of control, however, have not been studied in the in situ jejunum or in the transplanted bowel. The aim of this study was to determine if postprandial augmentation of absorption occurs in the in situ jejunum and to evaluate neural mechanisms controlling postprandial jejunal absorption.

The diurnal periodicity of hexose transporter mRNA and protein levels in the rat jejunum: role of vagal innervation.

Background: Protein and messenger RNA (mRNA) levels of the hexose transporters sodium-dependent glucose transporter-1, glucose transporter 2, and glucose transporter 5 follow a (daily) diurnal rhythm in rat jejunum. Because vagal innervation mediates the diurnal activity of other proteins in the rat small bowel, we hypothesized that the diurnal variation of mRNA and protein levels of these hexose transport proteins are mediated by vagal innervation.

Methods: Forty-eight rats kept in a strictly maintained, alternating 12-hour light-dark room underwent either sham laparotomy (n = 24) or bilateral total abdominal vagotomy (n = 24).

Bilateral staged versus bilateral simultaneous thoracotomy in the pediatric population.

Aim: The aim of the study was to evaluate the safety and outcomes of simultaneous bilateral thoracotomy in pediatric patients compared with traditional bilateral staged thoracotomy.

Methods: This is a retrospective review of 30 consecutive patients 18 years or younger undergoing either bilateral staged or bilateral simultaneous thoracotomy between March 1994 and July 2004. Follow-up (mean, 47 months) was available for all patients.

In vivo complete neural isolation of the rat jejunoileum: a simple model to study denervation sequelae of intestinal transplantation.

Background: Our aim was to develop and validate a technically easy, reliable, and reproducible method of complete jejunoileal denervation in the rat to allow study of the physiologic effects of intestinal transplantation devoid of immunologic phenomena and ischemia/reperfusion injury.

Materials And Methods: Six adult Sprague-Dawley rats underwent transection and reanastomosis of the proximal jejunum and proximal colon, transection of all neurolymphatic tissues at the base of the mesentery, stripping adventitia off the superior mesenteric artery and vein, and radial transection of the intervening mesenteries, thereby denervating the jejunoileum in situ without disrupting blood flow. Three rats each were sacrificed 1 and 6 months later.

Lung abscess due to retained gallstones with an adenocarcinoma.

We describe a patient who had a right lower lobe mass containing calcifications consistent with gallstones develop 3(1)/(2) years after laparoscopic cholecystectomy. Thoracotomy revealed a chronic abscess containing pigmented gallstones and an adjacent area of bronchoalveolar adenocarcinoma involving both N1 and N2 lymph nodes.

Surgical management of amiodarone-associated thyrotoxicosis: Mayo Clinic experience.

Amiodarone-associated thyrotoxicosis (AAT) is often poorly tolerated owing to underlying cardiac disease, and it is frequently refractory to conventional medical treatment. The goal of this study was to describe the patient characteristics, management, and outcomes of all the patients treated surgically for AAT at a single institution. We conducted a retrospective chart review of all patients managed surgically for AAT (April 1985 through November 2002) at the Mayo Clinic in Rochester, Minnesota.